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DSH390027BW TEMPLE UNIVERSITY HOSPITAL (Active)
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Main Details
Name
TEMPLE UNIVERSITY HOSPITAL
Subdivision Name
Infusion Services FCCC-TUH - Infusion Services FCCC-TUH
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390027BW
Medicare Provider Number
390027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/30/2024
Last Recertification Date
8/17/2024
Contacts
Authorizing Official
Temple University Hospital
Abhinav Rastogi, President & C.E.O
(215) 707-4299
Primary Contact
Temple University Hospital
Deborah Hauser, VP - CHIEF PHARMACY OFFICER
(215) 416-1682
Addresses
Street Address
333 Cottman Ave
Philadelphia, PA 19111
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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