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DSH100113Q SHANDS TEACHING HOSPITAL AND CLINICS, INC. (Terminated)
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Main Details
Name
SHANDS TEACHING HOSPITAL AND CLINICS, INC.
Subdivision Name
UF Health Spine & Sports Intervention Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100113Q
Medicare Provider Number
100113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/29/2016
Last Recertification Date
9/4/2019
Termination Date
Termination Reason
10/1/2020
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Shands Hospital and Teaching Clinics
Edward Jimenez, CEO
(352) 265-0440
Primary Contact
Shands Teaching Hospital & Clinics, Inc.
Thomas Johns, Associate Vice President, Operations
(352) 594-1321
Addresses
Street Address
4101 NW 89TH BLVD
GAINESVILLE, FL 32606
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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