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DSH390090P West Penn Hospital (Active)
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Main Details
Name
West Penn Hospital
Subdivision Name
West Penn Hospital Outpatient Services at Wexford
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390090P
Medicare Provider Number
390090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2016
Participating Start Date
4/1/2016
Participating Approval Date
2/29/2016
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
West Penn Hospital
Brian Johnson, President & CEO
(412) 578-1176
Primary Contact
West Penn Hospital
Robert W Simpson, Director, Pharmacy
(412) 266-8693
Addresses
Street Address
12311 Perry Highway Suite A
West Penn Hospital Outpatient Services at Wexford
Wexford, PA 15090-8344
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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