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DSH150056BN INDIANA UNIVERSITY HEALTH INC (Terminated)
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Main Details
Name
INDIANA UNIVERSITY HEALTH INC
Subdivision Name
IU Health Occupational Therapy / RH
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150056BN
Medicare Provider Number
150056
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/25/2012
Last Recertification Date
9/3/2019
Termination Date
Termination Reason
7/1/2020
Other
Contacts
Authorizing Official
Indiana University Health
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Primary Contact
IU Health
Lisa Stewart, Director - 340B Program
(317) 962-3540
Addresses
Street Address
705 Riley Hospital Drive
Indianapolis, IN 46202
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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