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DSH100113K SHANDS TEACHING HOSPITAL AND CLINICS, INC. (Active)
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Main Details
Name
SHANDS TEACHING HOSPITAL AND CLINICS, INC.
Subdivision Name
UF Health Shands Psychiatric Hospital
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100113K
Medicare Provider Number
100113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/5/2014
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Shands Teaching Hospital & Clinics Inc
Traci d'Auguste, Chief Operating Officer
(352) 294-8661
Primary Contact
Shands Teaching Hospital & Clinics, Inc.
Thomas Johns, Associate Vice President, Operations
(352) 594-1321
Addresses
Street Address
4101 NW 89th Boulevard
Gainesville, FL 32606
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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