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DSH390256AL PENN STATE - MILTON S. HERSHEY MEDICAL CENTER (Terminated)
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Main Details
Name
PENN STATE - MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
PSHMG Camp Hill HVI / Heart and Vascular
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256AL
Medicare Provider Number
390256
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/17/2016
Last Recertification Date
8/24/2021
Termination Date
Termination Reason
10/1/2022
Other
Contacts
Authorizing Official
Penn State Milton S. Hershey Medical Center
Julie B Nickell, CFO
(717) 531-4631
Primary Contact
Milton S Hershey Medical Center
Vince Lacroce, Administrative Director of Pharmacy
(717) 531-8972
Addresses
Street Address
3025 Market St.
Camp Hill, PA 17011
Billing Address
Penn State Milton S. Hershey Medical Center
500 University Dr
Hershey, PA 17033
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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