340B Drug Pricing Program Database
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DSH140091DZ The Carle Foundation Hospital (Active)
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Main Details
Name
The Carle Foundation Hospital
Subdivision Name
THE CARLE FOUNDATION HOSPITAL / Windsor Clinic - SE Urbana-Allergy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH140091DZ
Medicare Provider Number
140091
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2015
Participating Start Date
10/1/2015
Participating Approval Date
8/7/2015
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
1818 E WINDSOR RD
URBANA, IL 61802-9566
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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