340B Drug Pricing Program Database
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DSH140091DL The Carle Foundation Hospital (Terminated)
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Main Details
Name
The Carle Foundation Hospital
Subdivision Name
Windsor Clinic – SE Urbana – Neurology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140091DL
Medicare Provider Number
140091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/22/2014
Last Recertification Date
9/16/2022
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Carle Foundation Hospital
Dennis P. Hesch, Executive VP and CFO
(217) 326-8231
Primary Contact
Carle Foundation Hospital
Katie Koch, Director of 340B and Retail Pharmacy Operations
(217) 904-7016
Addresses
Street Address
1818 E. Windsor Rd.
Urbana, IL 61802
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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