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DSH150051D IU HEALTH BLOOMINGTON HOSPITAL (Terminated)
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Main Details
Name
IU HEALTH BLOOMINGTON HOSPITAL
Subdivision Name
I U HEALTH CHILDRENS THERAPY CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150051D
Medicare Provider Number
150051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/6/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/23/2016
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
10/1/2020
Other
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
4935 W ARLINGTON RD B
BLOOMINGTON, IN 47404-1141
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Previously participated as RRC150051-12 starting in 1/1/2014. Converted to a DSH 10/1/2016.
07/07/2016
June 2025
June 2025
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