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DSH150056P INDIANA UNIVERSITY HEALTH INC (Terminated)
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Main Details
Name
INDIANA UNIVERSITY HEALTH INC
Subdivision Name
IUH Infusion Center - South
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150056P
Medicare Provider Number
150056
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/31/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/13/2012
Last Recertification Date
9/7/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Indiana University Health
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Primary Contact
Dawn Moore, VP, Pharmacy Administration
(317) 948-0319
Addresses
Street Address
8830 S. Meridian Street
Indianapolis, IN 46217
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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