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DSH100006CG ORLANDO HEALTH (Active)
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Main Details
Name
ORLANDO HEALTH
Subdivision Name
Arnold Palmer Hospital / 1313 APH MOBILE TRANSPORT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006CG
Medicare Provider Number
100006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/18/2018
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Orlando Health
John Enoch Miller, SVP Finance
(321) 843-3180
Primary Contact
Orlando Health
Lacey Jory, 340B Program Supervisor
(321) 843-9045
Addresses
Street Address
92 W Miller Street
Orlando, FL 32806
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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