340B Drug Pricing Program Database
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DSH100007JJ AdventHealth Orlando (Active)
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Main Details
Name
AdventHealth Orlando
Subdivision Name
ADVENTHEALTH WINTER GARDEN CLINICAL DECISION UNIT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007JJ
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/5/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/21/2017
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
AdventHealth
Kent Johnson, Associate Chief Financial Officer
(407) 303-5786
Primary Contact
AdventHealth
Ashley Rajkumar, 340B Program Coordinator
(407) 577-8409
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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