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DSH520089N Meriter Health Services (Terminated)
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Main Details
Name
Meriter Health Services
Subdivision Name
UnityPoint Health-Meriter-Vein Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520089N
Medicare Provider Number
520089
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/17/2016
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
UnityPoint Health-Meriter
Beth Erdman, CFO
(608) 417-5800
Primary Contact
Meriter Health Services
Jeffrey Eugene Totten, 340B Program Administrator
(608) 417-6708
Addresses
Street Address
2601 W Beltline Hwy
Suite 300
Madison, WI 53713
Billing Address
Meriter Health Services
202 S Park Street
Madison, WI 53715
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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