340B Drug Pricing Program Database
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DSH170040DK UNIVERSITY OF KANSAS HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
PRAIRIE VILLAGE - Resident Peds Gen Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040DK
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
8/25/2020
Termination Date
Termination Reason
4/1/2021
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 300
PRAIRIE VILLAGE, KS 66208
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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