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DSH170040JH UNIVERSITY OF KANSAS HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
QCA UROLOGY CL - QCA Urology Cl (Urology QC)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040JH
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
12000 W 151ST ST
OLATHE, KS 66062-7200
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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