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CAH521352-03 Upland Hills Health Inc. (Terminated)
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Main Details
Name
Upland Hills Health Inc.
Subdivision Name
Upland Hills Health Dialysis Center
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521352-03
Medicare Provider Number
521352
Outpatient Facility Provider Number
522341
Additional Details
Current Program Status
Terminated
Registration Date
9/21/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/23/2011
Last Recertification Date
8/12/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Upland Hills Health, Inc.
Arthur K. Pustina, CFO
(608) 930-8000 Ext: 4102
Primary Contact
Upland Hills Health
Michael R Peterson, Director of Pharmacy
(608) 930-8000 Ext: 3250
Addresses
Street Address
800 Compassion Way
Dodgeville, WI 53533
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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