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DSH330394BP UNITED HEALTH SERVICES HOSPITALS, INC. (Terminated)
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Main Details
Name
UNITED HEALTH SERVICES HOSPITALS, INC.
Subdivision Name
Infusion Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330394BP
Medicare Provider Number
330394
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/10/2017
Participating Start Date
7/1/2017
Participating Approval Date
6/8/2017
Last Recertification Date
9/7/2022
Termination Date
Termination Reason
10/1/2023
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
United Health Services Hospitals, Inc.
James Mark Smith, Vice President - Chief Financial Officer
(607) 762-3011
Primary Contact
United Health Services Hospitals, Inc
Ryan C. Decaro, Pharmacy Business Manager
(607) 763-1838
Addresses
Street Address
33-57 Harrison Street
Johnson City, NY 13790
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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