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DSH150051M IU HEALTH BLOOMINGTON HOSPITAL (Active)
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Main Details
Name
IU HEALTH BLOOMINGTON HOSPITAL
Subdivision Name
IU HEALTH CANCER RADIATION CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150051M
Medicare Provider Number
150051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/29/2022
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Indiana University Health
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Primary Contact
IU Health, Inc.
Jennifer Ann Hatchett, Senior Financial Analyst
(317) 962-4243
Addresses
Street Address
2620 W COTA DR
BLOOMINGTON, IN 47403-4211
Billing Address
IU HEALTH BLOOMINGTON HOSPITAL
2651 EAST DISCOVERY PARKWAY
BLOOMINGTON, IN 47408
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 10/1/2016, Termination Date 10/1/2020, Reinstatement 10/1/2022
07/14/2022
June 2025
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