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DSH100007BG Florida Hospital (Terminated)
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Main Details
Name
Florida Hospital
Subdivision Name
Florida Hospital 9730 Genetic Counseling
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007BG
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/23/2014
Last Recertification Date
8/22/2016
Termination Date
Termination Reason
1/1/2018
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
AdventHealth Orlando
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Primary Contact
Laura Dale, 340B Business Manager
(407) 303-2037
Addresses
Street Address
2501 N. Orange Ave
Suite 249B
Orlando, FL 32804
Billing Address
Florida Hospital Orlando
601 E. Rollins St.
Orlando, FL 32803-1248
Comments
Medicaid Billing
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