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DSH390256BB PENN STATE - MILTON S. HERSHEY MEDICAL CENTER (Terminated)
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Main Details
Name
PENN STATE - MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
Medicine Specialties - Medicine specialties
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256BB
Medicare Provider Number
390256
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/17/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/24/2018
Last Recertification Date
9/1/2020
Termination Date
Termination Reason
4/1/2021
Other
Contacts
Authorizing Official
Penn State Health
Paula Marie Tinch, CFO & EVP Finance, PSH
(717) 531-1788
Primary Contact
Milton S Hershey Medical Center
Vince Lacroce, Administrative Director of Pharmacy
(717) 531-8972
Addresses
Street Address
200 Campus Drive
Suite 300
Hershey, PA 17033
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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