340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
TRINITY HEALTH PHARMACY SERVICES, LLC
DSH130007 Saint Alphonsus Regional Medical Center
Print
Covered Entity Details
Entity Name
Saint Alphonsus Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH130007
Entity Address
1055 N. Curtis Rd.
Boise, ID 83706
Medicare Provider Number
130007
Participating Start Date
4/1/2012
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
TRINITY HEALTH PHARMACY SERVICES, LLC
Pharmacy Address
12279 BLUFFTON RD
FORT WAYNE, IN 46809-3208
Pharmacy Comments
Contract Details
Approval Date
10/8/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lannie Checketts, RHM CFO Idaho Oregon Region
(208) 367-7347
Contract Pharmacy Representative
TRINITY HEALTH
ZACHARY ROBERTS, DIRECTOR OF SPECIALTY PHARMACY
(734) 343-7606
Signed By Date
10/8/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session