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CENTURA HEALTH PHARMACY AT ST ANTHONY NO
DSH060104 St. Anthony North Hospital
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Covered Entity Details
Entity Name
St. Anthony North Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060104
Entity Address
14300 Orchard Pkwy
Westminster, CO 80023
Medicare Provider Number
060104
Participating Start Date
10/1/2013
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
CENTURA HEALTH PHARMACY AT ST ANTHONY NO
Pharmacy Address
COMMONSPIRIT ST. ANTHONY NORTH HOSPITAL
14300 ORCHARD PKWY
OUTPATIENT PHARMACY
WESTMINSTER, CO 80023
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carol Travis, CFO
(720) 627-1230
Contract Pharmacy Representative
CENTURA HEALTH PHARMACY SERVICES
Brian Morganfield, Pharmacy Manager
(303) 426-2360
Signed By Date
4/13/2020
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