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DSH150051Q IU HEALTH BLOOMINGTON HOSPITAL (Terminated)
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Main Details
Name
IU HEALTH BLOOMINGTON HOSPITAL
Subdivision Name
PHYSICAL THERAPY - RSMC Outpatient
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150051Q
Medicare Provider Number
150051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/17/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/19/2018
Last Recertification Date
8/20/2019
Termination Date
Termination Reason
4/1/2020
Other
Contacts
Authorizing Official
Indiana University Health
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Primary Contact
IU Health, Inc.
Jennifer Ann Hatchett, Senior Financial Analyst
(317) 962-4243
Addresses
Street Address
9149 State Road 37
Bedford, IN 47421
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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