340B Drug Pricing Program Database
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DSH100006K ORLANDO HEALTH (Terminated)
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Main Details
Name
ORLANDO HEALTH
Subdivision Name
DT Orange Hosp Based Cardio Sp
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006K
Medicare Provider Number
100006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/31/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/19/2012
Last Recertification Date
11/21/2017
Termination Date
Termination Reason
7/1/2018
Site closure
Contacts
Authorizing Official
orlando health
BERNADETTE SPONG, CFO
(321) 841-5078
Primary Contact
Orlando Health
James Moye II, 340B Program Coordinator
(321) 841-6656
Addresses
Street Address
1222 South Orange Avenue
3rd floor
Orlando, FL 32806
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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