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DSH100006JQ ORLANDO HEALTH (Approved)
Main Details
Name
ORLANDO HEALTH
Subdivision Name
2458 DPH Imaging - CT Scan
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006JQ
Medicare Provider Number
100006
Outpatient Facility Provider Number
Contacts
Authorizing Official
Orlando Health
Leslie Flake Flake, CFO
(321) 841-5078
Primary Contact
Orlando Health
Lacey Jory, 340B Program Supervisor
(321) 843-9045
Additional Details
Current Program Status
Approved
Registration Date
4/5/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/19/2024
Last Recertification Date
Addresses
Street Address
9400 Turkey Lake Rd.
Orlando, FL 32819
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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