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DSH100007KE AdventHealth Orlando (Terminated)
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Main Details
Name
AdventHealth Orlando
Subdivision Name
ADVENTHEALTH WINTER GARDEN PAIN MANAGEMENT
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100007KE
Medicare Provider Number
100007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/6/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/1/2018
Last Recertification Date
8/27/2020
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
AdventHealth Orlando
Daniel Myers, Senior Vice President Finance
(407) 303-5501
Primary Contact
AdventHealth Orlando
Billy Taer, Reimbursement Manager
(407) 379-1507
Addresses
Street Address
2000 Fowler Grove Blvd
Winter Garden, FL 34787
Billing Address
AdventHealth Finance Shared Services AP
902 Inspiration Ave
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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