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DSH010033AC UNIVERSITY OF ALABAMA HOSPITAL (Active)
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Main Details
Name
UNIVERSITY OF ALABAMA HOSPITAL
Subdivision Name
Respiratory Therapy – Highlands - Respiratory Therapy – Highlands
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010033AC
Medicare Provider Number
010033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/14/2022
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
UAB Hospital
Susan Jennings, CFO, UAB Hospital
(205) 934-7659
Primary Contact
UAB Hospital
TOMIE ANN BOACKLE, Director, Informatics and Regulatory Affairs
(205) 975-9780
Addresses
Street Address
1201 11th Avenue South
Birmingham, AL 35205
Billing Address
The University of Alabama at Birmingham Attn: Accounts Payable
801 Financial Services Building
801 5th Avenue South
Birmingham, AL 35233
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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