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DSH100006AW ORLANDO HEALTH (Terminated)
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Main Details
Name
ORLANDO HEALTH
Subdivision Name
UF Health Cancer Center / 6803 ONC HC MED ONCOL CLIN STAFF
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006AW
Medicare Provider Number
100006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/28/2015
Last Recertification Date
8/25/2018
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
orlando health
BERNADETTE SPONG, CFO
(321) 841-5078
Primary Contact
Orlando Health
James Moye II, 340B Program Coordinator
(321) 841-6656
Addresses
Street Address
1111 Blackwood Avenue
Ocoee, FL 34761
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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