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DSH180040H JEWISH HOSPITAL AND ST MARY'S HEALTHCARE (JHSMH) (Terminated)
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Main Details
Name
JEWISH HOSPITAL AND ST MARY'S HEALTHCARE (JHSMH)
Subdivision Name
CANCER AND BLOOD SPECIALISTS, A SERVICE OF JEWISH HOSPITAL AND SAINT MARY'S HEALTHCARE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180040H
Medicare Provider Number
180040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2009
Participating Start Date
10/8/2009
Participating Approval Date
10/8/2009
Last Recertification Date
8/19/2016
Termination Date
Termination Reason
10/1/2017
Site closure
Contacts
Authorizing Official
University of Louisville Hospital
Steve Amsler, Senior Vice President of Operations
(502) 562-4122
Primary Contact
Katy Brogan, Pharmacy Manager
(502) 562-7036
Addresses
Street Address
1460 BLUEGRASS AVE
LOUISVILLE, KY 40215
Billing Address
Jewish Hospital
200 Abraham Flexner Way
Louisville, KY 40202-1818
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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