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DSH150091 HUNTINGTON MEMORIAL HOSPITAL (Active)
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Main Details
Name
HUNTINGTON MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH150091
Medicare Provider Number
150091
Additional Details
Current Program Status
Active
Registration Date
4/8/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/13/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Parkview Health System
Stanton Risser, Assoc Chief Financial Officer
(260) 266-9313
Primary Contact
Parkview Health
Stephanie Dickmeyer, 340B Program Supervisor
(260) 266-4408
Addresses
Street Address
2001 STULTS ROAD
HUNTINGTON, IN 46750
Billing Address
Parkview Memorial Hospital, INC
2200 Randallia Dr
Fort Wayne, IN 46805
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 7/1/2016, Termination Date 10/1/2020, Reinstatement 7/1/2022
04/12/2022
Participated starting 4/1/2011, terminated 7/1/2015. Reinstated 7/1/2016.
05/04/2016
04/29/11 DELETED MEDICAID#(WAS 100268810A)
04/29/2011
April 2025
April 2025
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