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DSH100052 WINTER HAVEN HOSPITAL (Active)
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Main Details
Name
WINTER HAVEN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100052
Medicare Provider Number
100052
Additional Details
Current Program Status
Active
Registration Date
11/23/2007
Participating Start Date
1/1/2008
Participating Approval Date
11/26/2007
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Baycare Health System
Carl Tremonti, Chief Financial Officer
(813) 870-4020
Primary Contact
BayCare Health System
Kyle J Brauer, Manager, BayCare Pharmacy Supply Chain
(813) 901-6376
Addresses
Street Address
200 AVENUE F, NE
WINTER HAVEN, FL 33881
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/1/08-DSH ADJ > 11.75%
11/23/2007
April 2025
April 2025
week
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