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DSH520098BN UNIVERSITY OF WI HOSPITALS & CLINICS (Terminated)
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Main Details
Name
UNIVERSITY OF WI HOSPITALS & CLINICS
Subdivision Name
WAISMAN CLINIC - CLINICS - GENETIC COUNSELOR SERVICES
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520098BN
Medicare Provider Number
520098
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/5/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/10/2022
Last Recertification Date
9/7/2023
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
1500 Highland 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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