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CENTURA HEALTH PHARMACY SERVICES
CAH061344-00 St. Thomas More Hospital
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Covered Entity Details
Entity Name
St. Thomas More Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061344-00
Entity Address
1338 PHAY AVENUE
CANON CITY, CO 81212
Medicare Provider Number
061344
Participating Start Date
7/1/2019
Last Recertification Date
9/8/2024
Pharmacy Details
Pharmacy Name
CENTURA HEALTH PHARMACY SERVICES
Pharmacy Address
2551 W. 84TH AVE
WESTMINSTER, CO 80031
Pharmacy Comments
Contract Details
Approval Date
1/3/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristi Olson, Chief Executive Officer
(719) 285-2039
Contract Pharmacy Representative
CENTURA HEALTH PHARMACY SERVICES
Brian Morganfield, Pharmacy Manager
(303) 426-2360
Signed By Date
1/3/2022
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