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DSH170040JG UNIVERSITY OF KANSAS HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
Lab Olathe Medical Pavilion A - OCA4 Lab- Olathe
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040JG
Medicare Provider Number
170040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/22/2024
Last Recertification Date
Contacts
Authorizing Official
University of Kansas Health System
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301
Primary Contact
The University of Kansas Hospital
Todd Holt, Pharmacy Operations Manager
(913) 945-8291
Addresses
Street Address
20375 W 151st St
Suite 451
Olathe, KS 66061
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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