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DSH390073F ALTOONA REGIONAL HEALTH SYSTEM (Terminated)
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Main Details
Name
ALTOONA REGIONAL HEALTH SYSTEM
Subdivision Name
University Pittsburgh Medical Center HUNTINGDON FAMILY PHYSICIANS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390073F
Medicare Provider Number
390073
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/30/2018
Last Recertification Date
Termination Date
Termination Reason
10/1/2019
Hospital Outpatient facility no longer eligible
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
9498 WILLIAM PENN HIGHWAY
UPMC ALTOONA - HUNTINGDON
HUNTINGDON, PA 16652-1726
Billing Address
HC Pharmacy Central-Procurement
3175 East Carson Street
Pittsburgh, PA 15203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date (07/01/2017) until terminated effective date (01/01/2018), reinstatement date effective (10/01/2018)
08/30/2018
Participating from effective date (07/01/2018) until terminated effective date (01/01/2018), reinstatement date effective (10/01/2018)
08/06/2018
June 2025
June 2025
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