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DSH100006L ORLANDO HEALTH (Terminated)
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Main Details
Name
ORLANDO HEALTH
Subdivision Name
Orlando Heart Center / 3217 OCOEE-DIAGNOSTIC HOSP BASED 2
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006L
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
9/4/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
orlando health
BERNADETTE SPONG, CFO
(321) 841-5078
Primary Contact
Orlando Health Inc.
Lacey Richardson, 340B Program Coordinator
(321) 843-9045
Addresses
Street Address
10000 W Colonial Drive
Suite 282
Ocoee, FL 34761
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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