340B Drug Pricing Program Database
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DSH170040AF KANSAS UNIVERSITY HOSPITAL (Terminated)
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Main Details
Name
KANSAS UNIVERSITY HOSPITAL
Subdivision Name
UNIV OF KS HOSP INDIAN CREEK CAMPUS - ICC PAIN MANAGEMENT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040AF
Medicare Provider Number
170040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/12/2018
Last Recertification Date
8/21/2019
Termination Date
Termination Reason
7/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Kansas Health System
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301
Primary Contact
University of Kansas Health System
Michael Starling, 340B Operations Manager
(913) 574-0231
Addresses
Street Address
10720 NALL AVE
OVERLAND PARK, KS 66211-1206
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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