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DSH170040JT UNIVERSITY OF KANSAS HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
OCB2 IM ENDO CL - OCB2 IM Endo Cl (Int Med Endocrinology Comm Olathe)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040JT
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
20805 W 151ST ST
STE 224
OLATHE, KS 66061-7249
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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