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DSH010033 UNIVERSITY OF ALABAMA HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF ALABAMA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010033
Medicare Provider Number
010033
Additional Details
Current Program Status
Active
Registration Date
11/21/2007
Participating Start Date
12/1/1992
Participating Approval Date
11/21/2007
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
UAB Hospital
Susan Jennings, CFO, UAB Hospital
(205) 934-7659
Primary Contact
UAB Hospital
TOMIE ANN BOACKLE, Director, Informatics and Regulatory Affairs
(205) 975-9780
Addresses
Street Address
619 S. 19th Street
BIRMINGHAM, AL 35249
Billing Address
The University of Alabama at Birmingham Attn: Accounts Payable
801 Financial Services Building
801 5th Avenue South
Birmingham, AL 35233
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/20/12 Parent entity DSH 010033 - change subentity name (Russell Ambulatory Pharmacy) to University of Alabama Hospital and change the subentity address to 619 S.19th Street, Birmingham, AL 35249 The subentity should have 2 ship to addresses: Central Pharmacy Service 619 S 19th Street Birmingham, AL 35249 and UAB Specialty Pharmacy 619 S 19th Street 4th floor Quarterback Tower Birmingham, AL 35249 DSH 010033A remove as it became DSH010033 DSH 010033B name change, remove "pharmacy" Ship to address is: University Medical Center Pharmacy 908 South 20th Street Birmingham, AL 35249 DSH 010033C remove and add UAB Specialty's "ship to" address for DSH 010033 (UAB Hospital) DSH 010033D need name change to Kirklin Clinic Ship to address is: Kirklin Clinic Pharmacy 2000 6th Avenue South Birmingham, AL 35249 DSH 010033E need name change to Community Health Family Practice Ship to address is: Community Health & Family Practice Pharmacy 930 South 20th Street Birmingham, AL 35249
01/20/2012
April 2025
April 2025
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