340B Drug Pricing Program Database
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DSH140091AL The Carle Foundation Hospital (Active)
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Main Details
Name
The Carle Foundation Hospital
Subdivision Name
Monticello Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140091AL
Medicare Provider Number
140091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/13/2014
Last Recertification Date
9/3/2024
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
1002 Medical Center Dr.
Monticello, IL 61856
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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