340B Drug Pricing Program Database
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DSH520089T Meriter Health Services (Terminated)
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Main Details
Name
Meriter Health Services
Subdivision Name
UnityPoint Health-Meriter-West Washington Clinic-Pediatrics - Pediatrics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH520089T
Medicare Provider Number
520089
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/9/2021
Last Recertification Date
Termination Date
Termination Reason
10/1/2022
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
UnityPoint Health-Meriter
Beth Erdman, CFO
(608) 417-5800
Primary Contact
Meriter Health Services
Jeffrey Eugene Totten, 340B Program Administrator
(608) 417-6708
Addresses
Street Address
345 W Washington Ave
Suite 100
Madison, WI 53703
Billing Address
Meriter Health Services
202 S Park St
Madison, WI 53715
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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