Covered Entity Details

DSH180141K UNIVERSITY OF LOUISVILLE HOSPITAL (Terminated) - information as of 4/29/2025 1:42:56 AM

Main Details

Name

UNIVERSITY OF LOUISVILLE HOSPITAL

Subdivision Name

UNIVERSITY MEDICAL CENTER, INC. / Pain Management Clinic

Type

Disproportionate Share Hospital

Rural

340B ID

DSH180141K

Medicare Provider Number

180141

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

7/1/2015

Participating Start Date

10/1/2015

Participating Approval Date

7/15/2015

Last Recertification Date

Termination Date
Termination Reason

10/1/2015
Site closure

Contacts

Authorizing Official

University of Louisville Hospital
Steve Amsler, Senior Vice President of Operations
(502) 562-4122

Primary Contact

University of Louisville Hospital
Jessie Morgan, Outpatient Pharmacy Manager
(502) 562-6742

Addresses

Street Address

530 S. JACKSON STREET
LOUISVILLE, KY 40202-1675

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Shipping Address 1

University of Louisville Hospital
550 S. Jackson St.
2nd Floor
Louisville, KY 40202

Shipping Address 2

University of Louisville Hospital
550 S. Jackson St.
1st Floor
Louisville, KY 40202

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH180141A	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BROWN CANCER CENTER	529 SOUTH JACKSON STREET	LOUISVILLE	KY	Terminated
DSH180141AA	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC Bluegrass Infusion - Infusion	1460 Bluegrass Ave	Louisville	KY	Active
DSH180141AB	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC MCNE Rad Onc - Radiology Oncology	2401 Terra Crossing Blvd	Louisville	KY	Active
DSH180141AC	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Multi-Specialty Clinic - Respitory Therapy	401 E. Chestnut Street	Louisville	KY	Active
DSH180141AD	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Advanced Bariatrics & Medical Weight Loss Clinic - Bariatrics	401 E. Chestnut Street	Louisville	KY	Active
DSH180141AE	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	UofL Health - University Hospital Infusion Center at Shelbyville Hospital - Infusion	727 Hospital Drive	Shelbyville	KY	Active
DSH180141AF	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC MCNE BCT Clinic - Bone Marrow Celluar Transplant	2401 Terra Crossing Blvd	Louisville	KY	Active
DSH180141AG	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	ULH MTM Clinic - Medication Therapy Management	550 South Jackson Street	Louisville	KY	Active
DSH180141AH	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC Bluegrass Clinic - Medical Oncology	1460 Bluegrass Avenue	Louisville	KY	Active
DSH180141AJ	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC Infusion Services - Infusion	529 South Jackson Street	Louisville	KY	Active
DSH180141B	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	OUTPATIENT SERVICES	530 SOUTH JACKSON STREET	LOUISVILLE	KY	Terminated
DSH180141C	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	HEALTH CARE OUTPATIENT CENTER	401 EAST CHESTNUT STREET, SUITE 180	LOUISVILLE	KY	Terminated
DSH180141D	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	UNIVERSITY MEDICAL CENTER, INC. / Outpatient Surgery Center	401 E Chestnut	LOUISVILLE	KY	Active
DSH180141E	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Cyberknife	529 South Jackson Street	Louisville	KY	Active
DSH180141F	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Medical Oncology	529 South Jackson Street	Louisville	KY	Active
DSH180141G	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Radiation Oncology	529 South Jackson Street	Louisville	KY	Active
DSH180141H	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Infusion Services	529 South Jackson Street	Louisville	KY	Active
DSH180141J	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Bone Marrow Transplant Clinic	529 South Jackson Street	Louisville	KY	Terminated
DSH180141K	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	UNIVERSITY MEDICAL CENTER, INC. / Pain Management Clinic	530 S. JACKSON STREET	LOUISVILLE	KY	Terminated
DSH180141L	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	UNIVERSITY MEDICAL CENTER, INC. / Interventional Nephrology Center	530 S. JACKSON STREET	LOUISVILLE	KY	Terminated
DSH180141M	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Interventional Nephrology Center	401 East Chestnut Street	Louisville	KY	Active
DSH180141N	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Bone Marrow Transplant Clinic	550 South Jackson Street	Louisville	KY	Active
DSH180141P	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Pain Management Clinic	550 South Jackson Street	Louisville	KY	Active
DSH180141Q	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Infusion Clinic	401 East Chestnut Street	Louisville	KY	Active
DSH180141R	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	OC Radiology - Radiology	401 East Chestnut Street	Louisville	KY	Active
DSH180141S	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Specialty Clinic - GI Clinic	550 South Jackson Street	Louisville	KY	Terminated
DSH180141T	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Specialty Clinic - Hepatitis C Center	550 South Jackson Street	Louisville	KY	Active
DSH180141U	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Specialty Clinic - MS Center - MS Clinic	550 South Jackson Street	Louisville	KY	Active
DSH180141V	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	MCNE BCC Infusion - Infusion	2401 Terra Crossing Blvd	Louisville	KY	Active
DSH180141W	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	Breast Services - Breast Services	529 South Jackson Street	Louisville	KY	Active
DSH180141X	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC Infusion 5E OP - Infusion	530 South Jackson Street	Louisville	KY	Active
DSH180141Y	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	PULMONARY CLINIC - Pulmonary Clinic	401 E CHESTNUT ST	LOUISVILLE	KY	Active
DSH180141Z	Child	DSH	UNIVERSITY OF LOUISVILLE HOSPITAL	BCC Bluegrass PET/ CT - Diagnostic	1460 Bluegrass Ave	Louisville	KY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Amsler, Steve Vice President of Operations University of Louisville Hospital 5025624122	Amsler, Steve Senior Vice President of Operations University of Louisville Hospital 5025624122	7/12/2024 9:19 AM
Contacts	Authorizing Official	Update		Amsler, Steve Vice President of Operations 5025624122	Amsler, Steve Vice President of Operations University of Louisville Hospital 5025624122	9/27/2017 2:10 PM
Contacts	Primary Contact	Update		Morgan, Jessie Outpatient Pharmacy Manager 5025626742	Morgan, Jessie Outpatient Pharmacy Manager University of Louisville Hospital 5025626742	9/26/2017 11:07 AM
Contacts	Authorizing Official	Update		Marshall, Ken President 5025626508	Amsler, Steve Vice President of Operations 5025624122	9/11/2017 3:29 PM
Contacts	Authorizing Official	Insert			Marshall, Ken President 5025626508	1/9/2017 4:40 PM
Contacts	Signed By	Insert			Marshall, Ken President 5025626508	1/9/2017 4:40 PM
Contacts	Primary Contact	Insert			Morgan, Jessie Outpatient Pharmacy Manager 5025626742	10/18/2016 7:42 AM
Dates	Last Date That 340B Drugs Purchased	Update			8/18/2015 12:00:00 AM	8/19/2015 7:30 AM
Details	State	Update		Active	Terminated	8/19/2015 7:30 AM
Terminations	Termination Comments	Update			This is a duplicate registration for the Pain Management clinic that occurred during the July 1-15th registration window. Please terminate this listing so this location will only have one registration.	8/19/2015 7:30 AM
Terminations	Termination Date	Update			10/1/2015 12:00:00 AM	8/19/2015 7:30 AM
Terminations	Termination Effective Date	Update			10/1/2015 12:00:00 AM	8/19/2015 7:30 AM
Terminations	Termination Reason	Update			Site closure	8/19/2015 7:30 AM
Addresses	Main Address	Insert			530 S. JACKSON STREET LOUISVILLE, KY 40202-1675	8/19/2015 7:30 AM
Addresses	Shipping Address	Insert			University of Louisville Hospital 550 S. Jackson St. 2nd Floor Louisville, KY 40202	8/19/2015 7:30 AM
Addresses	Shipping Address	Insert			University of Louisville Hospital 550 S. Jackson St. 1st Floor Louisville, KY 40202	8/19/2015 7:30 AM
Dates	Participating Approval Date	Update			7/15/2015 12:00:00 AM	7/15/2015 2:46 PM
Details	State	Update		Pending	Active	7/15/2015 2:46 PM
Dates	Start Date	Update			10/1/2015 12:00:00 AM	7/15/2015 2:46 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_52052	DSH180141K	7/6/2015 3:42 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_52052	7/1/2015 2:31 PM
Details	Last Recertification Date	Insert				7/1/2015 2:31 PM
Details	Grant Number	Insert				7/1/2015 2:31 PM
Details	340B ID	Insert				7/1/2015 2:31 PM
Details	Is Authorizing Official EHB Data	Insert				7/1/2015 2:31 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/1/2015 2:31 PM
Details	Medicare Provider Number	Insert			180141	7/1/2015 2:31 PM
Details	Entity Name	Insert			UNIVERSITY OF LOUISVILLE HOSPITAL	7/1/2015 2:31 PM
Details	Program Code	Insert			DSH	7/1/2015 2:31 PM
Details	Entity Subname	Insert			UNIVERSITY MEDICAL CENTER, INC. / Pain Management Clinic	7/1/2015 2:31 PM
Dates	Participating Approval Date	Insert				7/1/2015 2:31 PM
Details	State	Insert			Pending	7/1/2015 2:31 PM
Dates	Registration Date	Insert			7/1/2015 12:00:00 AM	7/1/2015 2:31 PM
Dates	Signed By Date	Insert			7/1/2015 12:00:00 AM	7/1/2015 2:31 PM
Dates	Start Date	Insert				7/1/2015 2:31 PM
Terminations	Termination Comments	Insert				7/1/2015 2:31 PM
Terminations	Termination Date	Insert				7/1/2015 2:31 PM
Terminations	Termination Effective Date	Insert				7/1/2015 2:31 PM
Terminations	Termination Reason	Insert				7/1/2015 2:31 PM