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DSH100006HU ORLANDO HEALTH (Terminated)
Main Details
Name
ORLANDO HEALTH
Subdivision Name
OSCEOLA FSED - 2176 DPO-OSCEOLA RESPIRATORY CARE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006HU
Medicare Provider Number
100006
Outpatient Facility Provider Number
Contacts
Authorizing Official
Orlando Health
Leslie Flake Flake, CFO
(321) 841-5078
Primary Contact
Orlando Health
Lacey Jory, 340B Program Supervisor
(321) 843-9045
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/4/2020
Last Recertification Date
8/21/2023
Termination Date
4/1/2024
Termination Reason
Business decision by the Covered Entity
Addresses
Street Address
1001 E OSCEOLA PKWY
KISSIMMEE, FL 34744
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2024
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