340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
INTERMOUNTAIN HEALTH SAINT JOSEPH HOSPIT
DSH060009B LUTHERAN MEDICAL CENTER
Print
Covered Entity Details
Entity Name
LUTHERAN MEDICAL CENTER
Subdivision Name
LMC Pulmonary Rehabilitation
Type
Disproportionate Share Hospital
340B ID
DSH060009B
Entity Address
9830 I-70 FRONTAGE RD S
PULMONARY REHABILITATION
WHEAT RIDGE, CO 80033
Medicare Provider Number
060009
Outpatient Facility Provider Number
Participating Start Date
4/1/2015
Last Recertification Date
8/16/2018
Entity Termination Date
1/1/2019
Pharmacy Details
Pharmacy Name
INTERMOUNTAIN HEALTH SAINT JOSEPH HOSPIT
Pharmacy Address
1825 MARION ST
DENVER, CO 80218
Pharmacy Comments
Contract Details
Approval Date
4/13/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Karen Scremin, Interim CFO
(303) 813-5255
Contract Pharmacy Representative
SCL Health
Chris Wilson, Pharmacy Manager
(303) 318-1313 Ext: 61313
Signed By Date
4/13/2015
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