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DSH100030 ORLANDO HEALTH-HEALTH CENTRAL HOSPIT (Active)
Main Details
Name
ORLANDO HEALTH-HEALTH CENTRAL HOSPIT
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100030
Medicare Provider Number
100030
Contacts
Authorizing Official
Orlando Health
Leslie Flake Flake, CFO
(321) 841-5078
Primary Contact
Orlando Health
Lacey Jory, 340B Program Supervisor
(321) 843-9045
Additional Details
Current Program Status
Active
Registration Date
10/5/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/17/2023
Last Recertification Date
Addresses
Street Address
10000 W. COLONIAL DRIVE
OCOEE, FL 34761
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2004, terminated 4/1/2020. Reinstated 1/1/2024.
10/16/2023
1/18/12 change AO from Richard Irwin to Mueller 2/26/07 INFORMATION SUBMITTED VERIFYING THAT DSH ADJUSTMENT % IS >11.75%
01/18/2012
2/26/07 INFORMATION SUBMITTED VERIFYING THAT DSH ADJUSTMENT % IS >11.75%
08/23/2007
May 2024
May 2024
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