340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KING SOOPERS PHARMACY #93
DSH060107 NATIONAL JEWISH MEDICAL AND RESEARCH CENTER
Print
Covered Entity Details
Entity Name
NATIONAL JEWISH MEDICAL AND RESEARCH CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH060107
Entity Address
1400 JACKSON STREET
DENVER, CO 80206
Medicare Provider Number
060107
Participating Start Date
10/1/2004
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
KING SOOPERS PHARMACY #93
Pharmacy Address
2810 QUEBEC ST
DENVER, CO 80207
Pharmacy Comments
Contract Details
Approval Date
7/29/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/5/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHRISTINE FORKNER, CFO
(303) 398-1004
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
7/29/2014
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