340B Drug Pricing Program Database
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DSH150056DM INDIANA UNIVERSITY HEALTH INC (Terminated)
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Main Details
Name
INDIANA UNIVERSITY HEALTH INC
Subdivision Name
IU Health Physical Therapy West
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150056DM
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
11/7/2012
Last Recertification Date
9/3/2019
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
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
6850 Parkdale Place
Suite 120
Indianapolis, IN 46254
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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