340B Drug Pricing Program Database
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DSH100173A AdventHealth TAMPA (Active)
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Main Details
Name
AdventHealth TAMPA
Subdivision Name
AdventHealth Wound Care Center Tampa
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100173A
Medicare Provider Number
100173
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/10/2016
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
AdventHealth Tampa
Tyson Davis, Chief Financial Officer
(813) 615-7159
Primary Contact
AdventHealth Tampa
Rey Velez, 340B Program Coordinator
(813) 615-7244
Addresses
Street Address
3000 MEDICAL PARK Drive
Suite 430
TAMPA, FL 33613
Billing Address
AdventHealth Tampa
c/o AdventHealth
902 Inspiration Avenue
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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