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DSH520098AJ UNIVERSITY OF WI HOSPITALS & CLINICS (Terminated)
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Main Details
Name
UNIVERSITY OF WI HOSPITALS & CLINICS
Subdivision Name
U STATION - CLINICS - GENERAL PEDIATRICS
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520098AJ
Medicare Provider Number
520098
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/5/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/14/2023
Last Recertification Date
8/21/2023
Termination Date
Termination Reason
4/1/2024
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
UW Health
Robert W Flannery, Senior VP/Chief Financial Officer
(608) 265-7131
Primary Contact
UW Health
Melissa Ngo, Manager-340B Operations and Support
(608) 662-2315
Addresses
Street Address
2880 UNIVERSITY AVE
MADISON, WI 53705
Billing Address
UW Health – Accounts Payable
PO Box 5448
Madison, WI 53705
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 7/1/2022, Termination Date 10/1/2022, Reinstatement 7/1/2023
04/07/2023
April 2025
April 2025
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