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DSH440015M UNIVERSITY OF TENNESSEE MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF TENNESSEE MEDICAL CENTER
Subdivision Name
Cole Neuroscience Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440015M
Medicare Provider Number
440015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/4/2014
Last Recertification Date
8/18/2016
Termination Date
Termination Reason
1/1/2017
Site closure
Contacts
Authorizing Official
University of Tennessee Medical Center
Steven Robert Ross, Senior Vice President, Strategic Development
(865) 305-6400
Primary Contact
University of Tennessee Medical Center
Kim C. Mason, Vice President, Pharmacy and Research
(865) 305-9124
Addresses
Street Address
1928 ALCOA HWY., STE 102
KNOXVILLE, TN 37920-1520
Billing Address
University Health System, Inc
Accts Payable
PO Box 32849
Knoxville, TN 37930-2849
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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