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DSH150056DZ INDIANA UNIVERSITY HEALTH INC (Terminated)
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Main Details
Name
INDIANA UNIVERSITY HEALTH INC
Subdivision Name
IU Health Home Hemodialysis Program
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150056DZ
Medicare Provider Number
150056
Outpatient Facility Provider Number
153521
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
9/7/2016
Termination Date
Termination Reason
10/1/2017
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
8803 N Meridian
Indianapolis, IN 46260
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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