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DSH390256 MILTON S. HERSHEY MEDICAL CENTER (Active)
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Main Details
Name
MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256
Medicare Provider Number
390256
Additional Details
Current Program Status
Active
Registration Date
10/29/2007
Participating Start Date
4/1/2004
Participating Approval Date
10/29/2007
Last Recertification Date
9/24/2024
Contacts
Authorizing Official
Penn State Health
Tracy L Moyer, Senior Vice President of Financial Operations
(717) 531-8477
Primary Contact
Penn State Health
Samuel Wetherill, VP Pharmacy
(410) 920-4494
Addresses
Street Address
500 UNIVERSITY DRIVE
HERSHEY, PA 17033
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/14/12 add medicaid number 3/24/10 BILL TO REMOVED/SHIP TO ADDED (PSCI SUITE T1100) - 11/13/09 UPDATED SHIP TO; 11/13/09 ADDED MEDICAID#; 9/1/09 DOC RECD TO CONFIRM ELIG DSH ADJ %
03/14/2012
3/24/10 BILL TO REMOVED/SHIP TO ADDED (PSCI SUITE T1100) - 11/13/09 UPDATED SHIP TO; 11/13/09 ADDED MEDICAID#; 9/1/09 DOC RECD TO CONFIRM ELIG DSH ADJ %
03/24/2010
May 2025
May 2025
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