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DSH440015P UNIVERSITY OF TENNESSEE MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF TENNESSEE MEDICAL CENTER
Subdivision Name
University Bariatric Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440015P
Medicare Provider Number
440015
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/17/2015
Last Recertification Date
Termination Date
Termination Reason
7/1/2016
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
1930 Alcoa Highway, A-240
Knoxville, TN 37920
Billing Address
University Health System, Inc
Accts Payable
PO Box 32849
Knoxville, TN 37930
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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