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DSH330394A UNITED HEALTH SERVICES HOSPITALS, INC. (Terminated)
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Main Details
Name
UNITED HEALTH SERVICES HOSPITALS, INC.
Subdivision Name
WILSON MEMORIAL REGIONAL MEDICAL CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330394A
Medicare Provider Number
330394
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/2/2009
Participating Start Date
9/4/2009
Participating Approval Date
9/4/2009
Last Recertification Date
8/22/2016
Termination Date
Termination Reason
1/1/2018
Other
Contacts
Authorizing Official
United Health Services Hospitals
Elizabeth kay Boland, Sr. VP/CNO/COO
(677) 636-6694
Primary Contact
United Health Services Hospitals, Inc
William Waldron, Associate Director of Pharmacy
(607) 763-1835
Addresses
Street Address
33-57 HARRISON STREET
JOHNSON CITY, NY 13790
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/1/2009 DOC RECD TO CONFIRM ELIG DSH ADJ%
09/04/2009
April 2025
April 2025
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