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DSH390256BL MILTON S. HERSHEY MEDICAL CENTER (Active)
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Main Details
Name
MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
Endoscopy UPC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256BL
Medicare Provider Number
390256
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/17/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/24/2018
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Penn State Health
Tracy L Moyer, Senior Vice President of Financial Operations
(717) 531-8477
Primary Contact
Penn State Health
Samuel Wetherill, VP Pharmacy
(410) 920-4494
Addresses
Street Address
200 Campus Drive
Suite 2100
Hershey, PA 17033
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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