340B Drug Pricing Program Database
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DSH150021R Parkview Hospital (Active)
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Main Details
Name
Parkview Hospital
Subdivision Name
PCI RADIATION ONC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH150021R
Medicare Provider Number
150021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/1/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/28/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Parkview Health System
Stanton Risser, Assoc Chief Financial Officer
(260) 266-9313
Primary Contact
Parkview Health
Stephanie Dickmeyer, 340B Program Supervisor
(260) 266-4408
Addresses
Street Address
11050 Parkview Circle Drive STE 1A
Fort Wayne, IN 46845-1728
Billing Address
Parkview Memorial Hospital, Inc
2200 Randallia Dr
Fort Wayne, IN 46805
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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