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DSH390027G TEMPLE UNIVERSITY HOSPITAL (Terminated)
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Main Details
Name
TEMPLE UNIVERSITY HOSPITAL
Subdivision Name
TUHE / EEG
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390027G
Medicare Provider Number
390027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/2/2016
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
Temple University Health System
Tony Reed, Chief Medical Officer
(215) 707-5880
Primary Contact
Temple University Hospital
Anaila Moreau, AVP 340b/Ambulatory Pharmacy Services
(215) 707-4642
Addresses
Street Address
100 E Lehigh
Philadelphia, PA 19125
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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