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DSH390073H ALTOONA REGIONAL HEALTH SYSTEM (Terminated)
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Main Details
Name
ALTOONA REGIONAL HEALTH SYSTEM
Subdivision Name
Altoona Family Physicians. FAMILY CENTERED OB GYN
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390073H
Medicare Provider Number
390073
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/3/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/26/2017
Last Recertification Date
Termination Date
Termination Reason
1/1/2018
DSH percentage below statutory minimum
Contacts
Authorizing Official
UPMC Altoona
Monica J Klatt, Chief Financial Officer
(814) 889-2223
Primary Contact
UPMC Altoona
Jill Breton, Director of Pharmacy
(814) 889-2825
Addresses
Street Address
501 HOWARD AVE STE F2
ALTOONA FAM PHY(S) FAM CENTERED OB/GYN
ALTOONA, PA 16601-4818
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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