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DSH140088G THE UNIVERSITY OF CHICAGO MEDICAL CENTER (Active)
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Main Details
Name
THE UNIVERSITY OF CHICAGO MEDICAL CENTER
Subdivision Name
The University of Chicago Outpatient Senior Health Center at South Shore
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH140088G
Medicare Provider Number
140088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/12/2013
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
The University of Chicago Medical Center
Denise Scarpelli, Vice President, Chief Pharmacy Officer
(773) 834-5601
Primary Contact
The University of Chicago Medical Center
Brent E Fiedler, Director, Pharmacy Contracting, Finance, and Metrics
(773) 702-2289
Addresses
Street Address
7101 S. Exchange Ave.
Chicago, IL 60649
Billing Address
The University of Chicago Medical Center
150 Harvester Drive, Suite 300
Burr Ridge, IL 60527
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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