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DSH010033G UNIVERSITY OF ALABAMA HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF ALABAMA HOSPITAL
Subdivision Name
UNIVERSITY OF ALABAMA INFUSION CENTER AT ACTON ROAD
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010033G
Medicare Provider Number
010033
Outpatient Facility Provider Number
010033
Additional Details
Current Program Status
Active
Registration Date
2/28/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/7/2011
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
UAB Hospital
Susan Jennings, CFO, UAB Hospital
(205) 934-7659
Primary Contact
UAB Hospital
TOMIE ANN BOACKLE, Director, Informatics and Regulatory Affairs
(205) 975-9780
Addresses
Street Address
2145 BONNER WAY
SUITE 101
BIRMINGHAM, AL 35243
Billing Address
The University of Alabama at Birmingham Attn: Accounts Payable
801 Financial Services Building
801 5th Avenue South
Birmingham, AL 35233
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/23/11 add NPI JH
12/23/2011
May 2025
May 2025
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