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DSH140133 HOLY CROSS HOSPITAL (Active)
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Main Details
Name
HOLY CROSS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140133
Medicare Provider Number
140133
Additional Details
Current Program Status
Active
Registration Date
7/1/2005
Participating Start Date
7/1/2005
Participating Approval Date
6/2/2005
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Holy Cross Hospital
Jeensoo Chang, President and Chief Medical Officer
(773) 884-1602
Primary Contact
Sinai Health System
Thomas Yu, System Director of Ambulatory Pharmacy Services
(773) 257-2486
Addresses
Street Address
2701 WEST 68TH STREET
CHICAGO, IL 60629
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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