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DSH010033AR UNIVERSITY OF ALABAMA HOSPITAL (Approved)
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Main Details
Name
UNIVERSITY OF ALABAMA HOSPITAL
Subdivision Name
UAB MEDICINE AT MEDICAL WEST - UAB Physical Med & Rehab Med West
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010033AR
Medicare Provider Number
010033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/8/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/14/2025
Last Recertification Date
Contacts
Authorizing Official
UAB Hospital
Susan Jennings, CFO, UAB Hospital
(205) 934-7659
Primary Contact
UAB Hospital
TOMIE ANN BOACKLE, Director, Informatics and Regulatory Affairs
(205) 975-9780
Addresses
Street Address
5000 MEDICAL WEST WAY
6TH FLOOR
BESSEMER, AL 35022
Billing Address
The University of Alabama at Birmingham Attn: Accounts Payable
801 Financial Services Building
801 5th Avenue South
Birmingham, AL 35233
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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