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DSH390164D UPMC - PRESBYTERIAN SHADYSIDE (Terminated)
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Main Details
Name
UPMC - PRESBYTERIAN SHADYSIDE
Subdivision Name
PUH-OP Theiss Health Ctr (34240) - THEISS HEALTH CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390164D
Medicare Provider Number
390164
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/26/2020
Last Recertification Date
9/10/2021
Termination Date
Termination Reason
4/1/2022
Site closure
Contacts
Authorizing Official
UPMC Aids Center for Treatment
Jared Weiner, CFO, UPMC Presbyterian Shadyside
(412) 864-7000
Primary Contact
UPMC Presbyterian
Alfred Adam L'Altrelli, Administrative Director of Pharmacy
(724) 554-9566
Addresses
Street Address
373 Burrows Street
Pittsburgh, PA 15213
Billing Address
HC Pharmacy Central
3175 East Carson Street
Pittsburgh, PA 15203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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