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DSH390027CQ TEMPLE UNIVERSITY HOSPITAL (Approved)
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Main Details
Name
TEMPLE UNIVERSITY HOSPITAL
Subdivision Name
TUHW-Radiology-Cat Scan - Cat Scan
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390027CQ
Medicare Provider Number
390027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/9/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/27/2025
Last Recertification Date
Contacts
Authorizing Official
Temple University Hospital
Abhinav Rastogi, President & C.E.O
(215) 707-4299
Primary Contact
Temple University Hospital
Deborah Hauser, VP - CHIEF PHARMACY OFFICER
(215) 416-1682
Addresses
Street Address
1331 East Wyoming Ave
Philadelphia, PA 19124
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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