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DSH390090M WEST PENN HOSPITAL (Terminated)
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Main Details
Name
WEST PENN HOSPITAL
Subdivision Name
AHN Center for Diabetes
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390090M
Medicare Provider Number
390090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/10/2015
Last Recertification Date
9/6/2016
Termination Date
Termination Reason
10/1/2016
Other
Contacts
Authorizing Official
West Penn Hospital
Ronald J Andro, President & CEO
(412) 578-1176
Primary Contact
West Penn Hospital
Jennifer Davis, Director
(412) 578-4050
Addresses
Street Address
5140 Liberty Avenue
Pittsburgh, PA 15224
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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