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DSH150051R IU HEALTH BLOOMINGTON HOSPITAL (Terminated)
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Main Details
Name
IU HEALTH BLOOMINGTON HOSPITAL
Subdivision Name
IU Health Cancer Services - OP Oncology Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH150051R
Medicare Provider Number
150051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/5/2020
Last Recertification Date
8/17/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
Indiana University Health
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Primary Contact
IU Health, Inc.
Jennifer Ann Hatchett, Senior Financial Analyst
(317) 962-4243
Addresses
Street Address
514 W. 2nd Street
Bloomington, IN 47403
Billing Address
IU HEALTH BLOOMINGTON HOSPITAL
2651 EAST DISCOVERY PARKWAY
BLOOMINGTON, IN 47408
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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