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IHC HEALTH SERVICES, INC.
DSH060004 Brighton Community Hospital Association DBA: Intermountain Health Platte Valley Hospital
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Covered Entity Details
Entity Name
Brighton Community Hospital Association DBA: Intermountain Health Platte Valley Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060004
Entity Address
1600 PRAIRIE CENTER PKWY.
BRIGHTON, CO 80601
Medicare Provider Number
060004
Participating Start Date
4/1/2006
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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