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DSH100113AD SHANDS TEACHING HOSPITAL AND CLINICS, INC. (Active)
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Main Details
Name
SHANDS TEACHING HOSPITAL AND CLINICS, INC.
Subdivision Name
Bronchoscopy and Pulmonary Pro - RESPIRATORY THERAPY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100113AD
Medicare Provider Number
100113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/17/2024
Last Recertification Date
Contacts
Authorizing Official
Shands Teaching Hospital & Clinics Inc
Traci d'Auguste, Chief Operating Officer
(352) 294-8661
Primary Contact
Shands Teaching Hospital & Clinics, Inc.
Thomas Johns, Associate Vice President, Operations
(352) 594-1321
Addresses
Street Address
1600 SW Archer Rd
Gainesville, FL 32610
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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