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DSH390115G ARIA HEALTH (Terminated)
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Main Details
Name
ARIA HEALTH
Subdivision Name
Aria Health Frankford Wound Care - Wound Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390115G
Medicare Provider Number
390115
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/20/2017
Last Recertification Date
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Jefferson Health
CARRIE FREY, Director of Finance
(215) 612-4313
Primary Contact
Aria Health
Dominic Webster, Administrative Director - Pharmacy Services
(215) 612-4180
Addresses
Street Address
5000 Frankford Ave.
Philadelphia, PA 19124
Billing Address
Aria Health
4900 Frankford Ave.
Philadelphia, PA 19124
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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