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DSH140091CL The Carle Foundation Hospital (Terminated)
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Main Details
Name
The Carle Foundation Hospital
Subdivision Name
Echo Program
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140091CL
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
5/13/2014
Last Recertification Date
9/6/2016
Termination Date
Termination Reason
10/1/2017
Site closure
Contacts
Authorizing Official
Carle Foundation Hospital
Dennis P. Hesch, Executive VP and CFO
(217) 326-8231
Primary Contact
Carle Health
Linda Fred, Vice President of Pharmacy Services
(217) 902-5803
Addresses
Street Address
805 West Park St.
Urbana, IL 61801
Billing Address
The Carle Foundation Hospital
611 West Park Street
Urbana, IL 61801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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