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DSH390256BZ MILTON S. HERSHEY MEDICAL CENTER (ToBeTerminated)
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Main Details
Name
MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
PSMG NYES ROAD - Audiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256BZ
Medicare Provider Number
390256
Outpatient Facility Provider Number
Additional Details
Current Program Status
ToBeTerminated
Registration Date
10/11/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/9/2022
Last Recertification Date
8/19/2024
Termination Date
Termination Reason
7/1/2025
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Penn State Health
Tracy L Moyer, Senior Vice President of Financial Operations
(717) 531-8477
Primary Contact
Penn State Health
Samuel Wetherill, VP Pharmacy
(410) 920-4494
Addresses
Street Address
121 NYES ROAD
STE B
HARRISBURG, PA 17112-3228
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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