340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SALIDA PHARMACY AND FOUNTAIN
CAH061322-00 Salida Hospital District DBA Heart of the Rockies Regional Medical Center
Print
Covered Entity Details
Entity Name
Salida Hospital District DBA Heart of the Rockies Regional Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061322-00
Entity Address
1000 Rush Drive
Salida, CO 81201
Medicare Provider Number
061322
Participating Start Date
1/1/2012
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
SALIDA PHARMACY AND FOUNTAIN
Pharmacy Address
PDO: BUENA VISTA DRUG
137 F ST
SALIDA, CO 81201
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lesley Fagerberg, VP Finance
(719) 530-2213
Contract Pharmacy Representative
Salida Pharmacy and Fountain
Lucas Smith, Owner
(719) 530-4790
Signed By Date
10/15/2020
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