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AMERITA INC.
DSH060024 UNIVERSITY OF COLORADO HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY OF COLORADO HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060024
Entity Address
12605 E 16th Ave
AURORA, CO 80045
Medicare Provider Number
060024
Participating Start Date
12/1/1992
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
AMERITA INC.
Pharmacy Address
7307 SOUTH REVERE PARKWAY
SUITE 200
CENTENNIAL, CO 80112-3931
Pharmacy Comments
Contract Details
Approval Date
4/13/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/17/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ANTHONY C. DEFURIO, VICE PRESIDENT, FINANCE/CFO
(720) 848-7836
Contract Pharmacy Representative
COLLEEN MOORE, PHARMACY MANAGER
(303) 355-4745
Signed By Date
4/13/2017
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