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DSH180141K UNIVERSITY OF LOUISVILLE HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF LOUISVILLE HOSPITAL
Subdivision Name
UNIVERSITY MEDICAL CENTER, INC. / Pain Management Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180141K
Medicare Provider Number
180141
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/15/2015
Last Recertification Date
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
University of Louisville Hospital
Steve Amsler, Senior Vice President of Operations
(502) 562-4122
Primary Contact
University of Louisville Hospital
Jessie Morgan, Outpatient Pharmacy Manager
(502) 562-6742
Addresses
Street Address
530 S. JACKSON STREET
LOUISVILLE, KY 40202-1675
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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