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DSH420004BM MEDICAL UNIVERSITY HOSPITAL AUTHORITY (Terminated)
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Main Details
Name
MEDICAL UNIVERSITY HOSPITAL AUTHORITY
Subdivision Name
East Cooper Occupational Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH420004BM
Medicare Provider Number
420004
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/13/2013
Last Recertification Date
11/30/2017
Termination Date
Termination Reason
4/1/2018
Site closure
Contacts
Authorizing Official
Medical University Hospital Authority
Thomas C Crawford, Chief Operating Officer
(843) 792-8775
Primary Contact
Medical University Hospital Authority
Heather Easterling, Director, Pharmacy Services
(843) 792-5691
Addresses
Street Address
1600 Midtown Avenue
room 2C13
Mount Pleasant, SC 29464
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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