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DSH390090J West Penn Hospital (Terminated)
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Main Details
Name
West Penn Hospital
Subdivision Name
West Penn Hospital Outpatient Services at Hansen
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390090J
Medicare Provider Number
390090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2013
Participating Start Date
7/1/2013
Participating Approval Date
6/14/2013
Last Recertification Date
9/10/2018
Termination Date
Termination Reason
7/1/2019
Site closure
Contacts
Authorizing Official
West Penn Hospital
Ronald J Andro, President & CEO
(412) 578-1176
Primary Contact
West Penn Hospital
Robert W Simpson, Director, Pharmacy
(412) 266-8693
Addresses
Street Address
300 HANSEN PLAZA
LYNDORA, PA 16045-1610
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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