340B Drug Pricing Program Database
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DSH060076B STERLING REGIONAL MEDCENTER (Active)
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Main Details
Name
STERLING REGIONAL MEDCENTER
Subdivision Name
STERLING REGIONAL MEDCENTER - Sterling Regional MedCenter- Family Care Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060076B
Medicare Provider Number
060076
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/9/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/31/2023
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Ogallala Community Hospital
DENA KLOCKMAN, CHIEF FINANCIAL OFFICER
(308) 284-7263
Primary Contact
Banner
Michele Masters, Associate Director, Pharmacy
(970) 740-3177
Addresses
Street Address
615 FAIRHURST STREET
STERLING, CO 80751-4523
Billing Address
Banner Health Accounts Payable
PO BOX 2977
Phoenix, AZ 85062
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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