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DSH100113A SHANDS TEACHING HOSPITAL AND CLINICS, INC. (Terminated)
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Main Details
Name
SHANDS TEACHING HOSPITAL AND CLINICS, INC.
Subdivision Name
SHANDS CANCER CENTER, UNIVERSITY OF FLORIDA
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100113A
Medicare Provider Number
100113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/14/2007
Participating Start Date
1/1/1995
Participating Approval Date
9/14/2007
Last Recertification Date
8/19/2015
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Shands Hospital and Teaching Clinics
Edward Jimenez, CEO
(352) 265-0440
Primary Contact
Shands Teaching Hospital & Clinics, Inc.
Thomas Johns, Associate Vice President, Operations
(352) 594-1321
Addresses
Street Address
2000 SW ARCHER ROAD
GAINESVILLE, FL 32610
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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