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DSH330394AS UNITED HEALTH SERVICES HOSPITALS, INC. (Terminated)
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Main Details
Name
UNITED HEALTH SERVICES HOSPITALS, INC.
Subdivision Name
UHS Wilson Square - Cardiothoracic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330394AS
Medicare Provider Number
330394
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/7/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/26/2012
Last Recertification Date
8/22/2016
Termination Date
Termination Reason
1/1/2017
Site closure
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
30 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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