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DSH390256CB MILTON S. HERSHEY MEDICAL CENTER (Approved)
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Main Details
Name
MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
Campus Drive Suite 1300- Medicine-Pulmonology General - Pulmonology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256CB
Medicare Provider Number
390256
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/2/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/7/2025
Last Recertification Date
Contacts
Authorizing Official
Penn State Health
Tracy L Moyer, Senior Vice President of Financial Operations
(717) 531-8477
Primary Contact
Penn State Health
Samuel Wetherill, VP Pharmacy
(410) 920-4494
Addresses
Street Address
200 Campus Dr.
1300
Hershey, PA 17033
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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