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DSH390174A THOMAS JEFFERSON UNIVERSITY HOSPITAL (Terminated)
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Main Details
Name
THOMAS JEFFERSON UNIVERSITY HOSPITAL
Subdivision Name
METHODIST HOSPITAL DIVISION, TJUH
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390174A
Medicare Provider Number
390174
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/29/2006
Participating Start Date
10/1/2006
Participating Approval Date
8/30/2006
Last Recertification Date
9/1/2015
Termination Date
Termination Reason
10/1/2015
Other
Contacts
Authorizing Official
TJUH Inc
Andrew Nathans, Vice president Finance, TJUH Inc.
(215) 955-6599
Primary Contact
FRANCIS NATALE, DIRECTOR OF PHARMACY
(215) 952-9260
Addresses
Street Address
2301 SOUTH BROAD STREET
PHILADELPHIA, PA 19148
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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