340B Drug Pricing Program Database
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DSH170040DC UNIVERSITY OF KANSAS HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
Pediatrics Behav Health PV
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040DC
Medicare Provider Number
170040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/11/2019
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Kansas Health System
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301
Primary Contact
University of Kansas Health System
Michael Starling, 340B Operations Manager
(913) 574-0231
Addresses
Street Address
7301 Mission Rd
Ste 319
PRAIRIE VILLAGE, KS 66208
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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