340B Drug Pricing Program Database
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DSH100006JJ ORLANDO HEALTH (Terminated)
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Main Details
Name
ORLANDO HEALTH
Subdivision Name
RANDAL PARK FSED - 2183 RANDAL PARK IMAGING - Imaging
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100006JJ
Medicare Provider Number
100006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
1/24/2023
Last Recertification Date
8/21/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Orlando Health
Leslie Flake Flake, CFO
(321) 841-5078
Primary Contact
Orlando Health
Lacey Jory, 340B Program Supervisor
(321) 843-9045
Addresses
Street Address
10155 Dowden Road
Orlando, FL 32832
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
April 2025
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