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SCH170191-00 UKHS GREAT BEND CAMPUS (Active)
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Main Details
Name
UKHS GREAT BEND CAMPUS
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH170191-00
Medicare Provider Number
170191
Additional Details
Current Program Status
Active
Registration Date
10/2/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/23/2018
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
University of Kansas Health System
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301
Primary Contact
The University of Kansas Hospital
Todd Holt, Pharmacy Operations Manager
(913) 945-8291
Addresses
Street Address
514 CLEVELAND
GREAT BEND, KS 67530
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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