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DSH180040A JEWISH HOSPITAL AND ST MARY'S HEALTHCARE (JHSMH) (Terminated)
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Main Details
Name
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE (JHSMH)
Subdivision Name
DBA Amerimed1
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180040A
Medicare Provider Number
180040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/14/2005
Participating Start Date
12/15/2005
Participating Approval Date
12/15/2005
Last Recertification Date
11/13/2017
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Louisville Hospital
Steve Amsler, Senior Vice President of Operations
(502) 562-4122
Primary Contact
KentuckyOne Health
Sherie Gower, Manager
(502) 585-7677
Addresses
Street Address
5111 COMMERCE CROSSING DRIVE
SUITE 130
LOUISVILLE, KY 40229
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/27/08- UPDATED MEDICAID # (WAS 34028563); 3/28/06 - UPDATE ADDRESS - OLD ADDRESS WAS 101 W CHESTNUT STREET
12/23/2010
2/27/08- UPDATED MEDICAID # (WAS 34028563); 3/28/06 - UPDATE ADDRESS - OLD ADDRESS WAS 101 W CHESTNUT STREET
12/23/2010
April 2025
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