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DSH150056A INDIANA UNIVERSITY HEALTH INC (Terminated)
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Main Details
Name
INDIANA UNIVERSITY HEALTH INC
Subdivision Name
Riley Hospital for Children
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150056A
Medicare Provider Number
150056
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/1/2007
Participating Start Date
4/1/2004
Participating Approval Date
12/1/2007
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Indiana University Health
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Primary Contact
IU Health, Inc.
Jennifer Ann Hatchett, Senior Financial Analyst
(317) 962-4243
Addresses
Street Address
705 Riley Hospital Drive
Indianapolis, IN 46202
Billing Address
IU Health Methodist Hospital
1701 N. Senate Blvd
Indianapolis, IN 46202
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/4/12 JH error in aletering child site A data, data reinstated JH; 09/01/2011 NAME CHANGE FROM CLARIAN HEALTH PARTNERS; 9/22/04 ADDED RILEY PRESCRIPTION CENTER TO NAME; 4/1/04 REINSTATED PREV PART 1/1/1995 TO 6/30/1998, INELIGIBLE 7/1/1998 TO 3/31/2004
10/25/2012
10/4/12 JH error in aletering child site A data, data reinstated JH4/1/04 REINSTATED PREV PART 1/1/1995 TO 6/30/1998, INELIGIBLE 7/1/1998 TO 3/31/2004, 9/22/04 ADDED RILEY PRESCRIPTION CENTER TO NAME
10/04/2012
10/4/12 Changes to database after review of Medicare cost report and correlation with IU legal councel and CFO to switch 340B ID Chils site A previously sub name Riley Hospital for Children with previous parent site University Hospital. After merger child site per medicare report became parent and these changes reflect this. JH4/1/04 REINSTATED PREV PART 1/1/1995 TO 6/30/1998, INELIGIBLE 7/1/1998 TO 3/31/2004, 9/22/04 ADDED RILEY PRESCRIPTION CENTER TO NAME
10/04/2012
4/1/04 REINSTATED PREV PART 1/1/1995 TO 6/30/1998, INELIGIBLE 7/1/1998 TO 3/31/2004, 9/22/04 ADDED RILEY PRESCRIPTION CENTER TO NAME
12/01/2007
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