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DSH330394BK UHS (Terminated)
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Main Details
Name
UHS
Subdivision Name
UHS Cardiology Johnson City
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330394BK
Medicare Provider Number
330394
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/20/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/19/2016
Last Recertification Date
Termination Date
Termination Reason
1/1/2017
Site closure
Contacts
Authorizing Official
United Health Services Hospitals
Elizabeth kay Boland, Sr. VP/CNO/COO
(677) 636-6694
Primary Contact
United Health Services Hospitals, Inc
William Waldron, Associate Director of Pharmacy
(607) 763-1835
Addresses
Street Address
30 Harrison St.
Suite 355
Johnson City, NY 13790
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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