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IHC HEALTH SERVICES, INC.
DSH060028 Saint Joseph Hospital, Inc. DBA Intermountain Health Saint Joseph Hospital
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Covered Entity Details
Entity Name
Saint Joseph Hospital, Inc. DBA Intermountain Health Saint Joseph Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060028
Entity Address
1375 EAST 19TH AVENUE
DENVER, CO 80218
Medicare Provider Number
060028
Participating Start Date
7/1/2016
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
IHC HEALTH SERVICES, INC.
Pharmacy Address
DBA: INTERMOUNTAIN HOME DELIVERY PHARMAC
DBA: INTERMOUNTAIN SPECIALTY PHARMACY
7268 S BINGHAM JUNCTION BLVD STE B1
MIDVALE, UT 84047
Pharmacy Comments
Contract Details
Approval Date
10/6/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Troy Stoehr, VP of Finance
(303) 498-1606
Contract Pharmacy Representative
Intermountain Healthcare
Carrie Dunford, Chief Pharmacy Officer
(801) 284-1004
Signed By Date
10/6/2023
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