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DSH170040Q UNIVERSITY OF KANSAS HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
CC CRC EXAM/PROC RM
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040Q
Medicare Provider Number
170040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/12/2013
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
University of Kansas Health System
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301
Primary Contact
The University of Kansas Hospital
Todd Holt, Pharmacy Operations Manager
(913) 945-8291
Addresses
Street Address
4350 Shawnee Mission Pkwy.
Level 2
Suite 2200
Fairway, KS 66205-2528
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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