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DSH150021BU Parkview Hospital (Terminated)
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Main Details
Name
Parkview Hospital
Subdivision Name
PRMC Center on Aging and Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH150021BU
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
8/14/2023
Termination Date
Termination Reason
10/1/2023
Site closure
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
11104 Parkview Circle Dr STE 40
Fort Wayne, IN 46845-4638
Billing Address
Parkview Memorial Hospital, Inc
2200 Randallia Drive
Fort Wayne, IN 46805
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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