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DSH390027BP TEMPLE UNIVERSITY HOSPITAL (Terminated)
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Main Details
Name
TEMPLE UNIVERSITY HOSPITAL
Subdivision Name
TUHN-Wound Care - TUHN-Wound Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390027BP
Medicare Provider Number
390027
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2021
Participating Start Date
7/1/2021
Participating Approval Date
5/4/2021
Last Recertification Date
9/14/2022
Termination Date
Termination Reason
10/1/2023
Other
Contacts
Authorizing Official
Temple University Hospital
Abhinav Rastogi, President & C.E.O
(215) 707-4299
Primary Contact
Temple University Health System
Shawn Parekh, VP CPO
(215) 707-4524
Addresses
Street Address
2301 E Allegheny Ave
Philadelphia, PA 19134
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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