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DSH100052A WINTER HAVEN HOSPITAL (Terminated)
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Main Details
Name
WINTER HAVEN HOSPITAL
Subdivision Name
Winter Haven Women's Hospital
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100052A
Medicare Provider Number
100052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/17/2007
Participating Start Date
1/1/2008
Participating Approval Date
12/17/2007
Last Recertification Date
8/31/2015
Termination Date
Termination Reason
4/1/2016
Other
Contacts
Authorizing Official
Baycare Health System
Carl Tremonti, Chief Financial Officer
(813) 870-4020
Primary Contact
BayCare Health System
Michael Magee, Vice President of Pharmacy
(813) 870-4020
Addresses
Street Address
101 AVENUE O, SE
WINTER HAVEN, FL 33880
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%
12/17/2007
April 2025
April 2025
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