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DSH100006HF ORLANDO HEALTH (Terminated)
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Main Details
Name
ORLANDO HEALTH
Subdivision Name
Orlando Regional Medical Center - 0140 LP 8 MEDICAL ONCOLOGY - Medical Oncology -Observation
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006HF
Medicare Provider Number
100006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/10/2018
Participating Start Date
7/1/2018
Participating Approval Date
5/3/2018
Last Recertification Date
9/14/2022
Termination Date
Termination Reason
4/1/2023
Other
Contacts
Authorizing Official
Orlando Health
Leslie Flake Flake, CFO
(321) 841-5078
Primary Contact
Orlando Health
Lacey Jory, 340B Program Supervisor
(321) 843-9045
Addresses
Street Address
52 W Underwood Street
Orlando, FL 32806
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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