340B Drug Pricing Program Database
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DSH150021BQ Parkview Hospital (Terminated)
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Main Details
Name
Parkview Hospital
Subdivision Name
PVH IV Team
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH150021BQ
Medicare Provider Number
150021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/18/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/9/2016
Last Recertification Date
8/20/2020
Termination Date
Termination Reason
1/1/2021
Other
Contacts
Authorizing Official
Parkview Health
Jeanne Wickens, CFO
(260) 373-8407
Primary Contact
Parkview Health
Stephanie Dickmeyer, 340B Program Supervisor
(260) 266-4408
Addresses
Street Address
2200 Randallia Drive
Fort Wayne, IN 46805-4638
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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