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CAN100079-114 UNIVERSITY OF MIAMI HOSPITAL AND CLINICS (Terminated)
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Main Details
Name
UNIVERSITY OF MIAMI HOSPITAL AND CLINICS
Subdivision Name
UMH: MRI - MRI
Type
Free Standing Cancer Hospital
Rural
No
340B ID
CAN100079-114
Medicare Provider Number
100079
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/19/2018
Last Recertification Date
9/6/2018
Termination Date
Termination Reason
10/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Miami Hospital and Clinics
Kymberlee Manni, CEO
(305) 689-4515
Primary Contact
University of Miami Hospital and Clinics
Blanca Rivera, Associate Vice President, UHealth Pharmacy Services
(305) 689-5630
Addresses
Street Address
1400 NW 12th Avenue
Miami, FL 33136
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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