340B Drug Pricing Program Database
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DSH170040FK UNIVERSITY OF KANSAS HOSPITAL (Terminated)
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Main Details
Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
Rehab Medicine KUMW
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH170040FK
Medicare Provider Number
170040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/3/2021
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
7/1/2022
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
7405 RENNER RD
Level 2
Pod 2C
SHAWNEE, KS 66217-9414
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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