340B Drug Pricing Program Database
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DSH100173C AdventHealth TAMPA (Active)
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Main Details
Name
AdventHealth TAMPA
Subdivision Name
AdventHealth Brandon ER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100173C
Medicare Provider Number
100173
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/3/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/3/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
AdventHealth Tampa
Tyson Davis, Chief Financial Officer
(813) 615-7159
Primary Contact
AdventHealth Tampa
Rey Velez, 340B Program Coordinator
(813) 615-7244
Addresses
Street Address
305 East Brandon Boulevard
Brandon, FL 33511
Billing Address
AdventHealth Tampa
C/O AdventHealth
902 Inspiration Avenue
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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