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DSH520098CT UNIVERSITY OF WI HOSPITALS & CLINICS (Terminated)
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Main Details
Name
UNIVERSITY OF WI HOSPITALS & CLINICS
Subdivision Name
WIMR - Imaging - Radiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520098CT
Medicare Provider Number
520098
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/3/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/11/2024
Last Recertification Date
8/23/2024
Termination Date
Termination Reason
4/1/2025
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
Dan Schenkat, Director of Pharmacy - Business Services and East Madison Hospital
(608) 203-4897
Addresses
Street Address
1111 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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Participating Start Date 10/1/2022,Termination Date 4/1/2023, Reinstatement 4/1/2024.
01/08/2024
April 2025
April 2025
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