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DSH100007JX AdventHealth Orlando (Terminated)
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Main Details
Name
AdventHealth Orlando
Subdivision Name
ADVENTHEALTH WINTER GARDEN MAMMOGRAPHY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007JX
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/5/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/21/2017
Last Recertification Date
8/25/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
AdventHealth Orlando
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Primary Contact
AdventHealth Orlando
Billy Taer, Reimbursement Manager
(407) 379-1507
Addresses
Street Address
2000 Fowler Grove Blvd
Winter Garden, FL 34787-0001
Billing Address
AdventHealth Finance Shared Services AP
902 Inspiration Ave
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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