Geographic Directory of Listed Patient Safety Organizations (continued)

Street Address: 1800 Howell Mill Road, Suite 850; Atlanta, GA 30318
Mailing Address: Same as street address
Phone: (404) 425-1307
Fax: (404) 503-9275
Web Site: www.piedmontclinic.org
Point of Contact: Stephen Heimbigner, MHA, MBA, MPH
Point of Contact Phone: (770) 801-2376
Point of Contact Email: stephen.heimbigner@piedmont.org
Two Contract Certification Due By 02/10/2012: Requirement Fulfilled on 12/02/2011
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 520 North Northwest Highway; Park Ridge, IL 60068
Mailing Address: Same as street address
Phone: (847) 268-9226
Fax: (847) 825-2085
Web Site: www.aqihq.org
Point of Contact: Richard P Dutton, M.D., M.B.A.
Point of Contact Phone: (847) 268-9226
Point of Contact Email: r.dutton@asahq.org
Two Contract Certification Due By 09/22/2012: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 1645 West Jackson Blvd, Suite 450; Chicago, IL 60612
Mailing Address: Same as street address
Phone: (312) 942-0309
Fax: (312) 563-2448
Web Site: www.chicagobreastcancer.org
Point of Contact: Anne Marie Murphy, Ph.D.
Point of Contact Phone: (312) 942-0309
Point of Contact Email: anne_m_murphy@rush.edu
Two Contract Certification Due By 09/16/2013: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 8725 West Higgins Road, Suite 810; Chicago, IL 60631
Mailing Address: Same as street address
Phone: (773) 867-8066
Fax: (773) 864-8281
Web Site: www.claritygrp.com
Point of Contact: Thomas F. Piotrowski
Point of Contact Phone: (773) 867-8066
Point of Contact Email: tpiotrowski@claritypso.com
Two Contract Certification Due By 11/19/2012: Requirement Fulfilled on 08/30/2011
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 405 North Wabash Avenue, Suite P2W; Chicago, IL 60611
Mailing Address: Same as street address
Phone: (312) 464-0600
Fax: (312) 464-0607
Web Site: Not Provided
Point of Contact: Martin J Hatlie
Point of Contact Phone: (312) 464-0600
Point of Contact Email: mhatlie@p4ps.net
Two Contract Certification Due By 05/26/2012: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 633 North Saint Clair Street; Chicago, IL 60611
Mailing Address: Same as street address
Phone: (312) 334-2300
Fax: (312) 334-2320
Web Site: www.vascularweb.org
Point of Contact: Carrie Bosela, RN, CPC, CPC-I
Point of Contact Phone: (603) 298-5509 Ext. 329
Point of Contact Email: c.bosela@svspso.org
Two Contract Certification Due By 02/16/2013: Requirement Fulfilled on 03/29/2011
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 222 South Riverside Plaza, Suite 1900; Chicago, IL 60606
Mailing Address: Same as street address
Phone: (312) 906-6064
Fax: (312) 906-6123
Web Site: www.MidwestAlliancePSO.org
Point of Contact: Marie Cleary Fishman
Point of Contact Phone: (630) 276-5585
Point of Contact Email: MCleary-Fishman@ihastaff.org
Two Contract Certification Due By 04/28/2012: Requirement Fulfilled on 05/26/2011
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 200 Wilmot Road; Deerfield, IL 60015-4681
Mailing Address: Same as street address
Phone: (847) 315-2159
Fax: (847) 315-3109
Web Site: Not Provided
Point of Contact: Averill D. Gordon, PharmD
Point of Contact Phone: (847) 914-2159
Point of Contact Email: averill.gordon@walgreens.com
Two Contract Certification Due By 01/14/2013: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: Yes

Street Address: 155 North Wacker Drive; Chicago, IL 60606
Mailing Address: Same as street address
Phone: (312) 775-4100
Fax: (312) 775-4580
Web Site: www.uhc.edu
Point of Contact: Crystal Wilson
Point of Contact Phone: (312) 775-4381
Point of Contact Email: cwilson@uhc.edu
Two Contract Certification Due By 11/05/2012: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: P.O. Box 2475; Anderson, IN 46018
Mailing Address: Same as street address
Phone: Not Provided
Fax: (866) 267-0777
Web Site: www.qaisys.com
Point of Contact: Richard B. Dale
Point of Contact Phone: (765) 606-8601
Point of Contact Email: rdale@qaisys.com
Two Contract Certification Due By 02/04/2013: Information Not Received
Disclosures & Findings: The Department of Health and Human Services determined no action was required regarding the PSO's relationships with the following contracting provider(s):

• St. Vincent Mercy Hospital and its staff, Elwood, IN

Street Address: 6803 West 64th Street; Shawnee Mission, KS 66202
Mailing Address: Same as street address
Phone: (913) 981-4118
Fax: (913) 766-7817
Web Site: www.chca.com
Point of Contact: Barbara Weis
Point of Contact Phone: (913) 981-4117
Point of Contact Email: barbara.weis@chca.com
Two Contract Certification Due By 10/12/2013: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 2501 Nelson Miller Parkway; Louisville, KY 40253
Mailing Address: P.O. Box 436629; Louisville, KY 40253
Phone: (502) 426-6220
Fax: (502) 426-6226
Web Site: www.kentuckypatientsafety.org
Point of Contact: Nancy C. Galvagni
Point of Contact Phone: (502) 426-6220
Point of Contact Email: ngalvagni@kyha.com
Two Contract Certification Due By 11/26/2012: Requirement Fulfilled on 11/30/2010
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 250 East Liberty, Suite 800; Louisville, KY 40202
Mailing Address: Same as street address
Phone: (502) 384-2442
Fax: (502) 384-2445
Web Site: www.TheACB.org
Point of Contact: Jason Holman, MBA
Point of Contact Phone: (502) 569-1032
Point of Contact Email: jason.holman@TheACB.org
Two Contract Certification Due By 04/22/2013: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 2045 Highway 59; Mandeville, LA 70448
Mailing Address: P.O. Box 880; Mandeville, LA 70470
Phone: (888) 395-4200
Fax: (985) 624-9449
Web Site: www.carerise.com
Point of Contact: Liz Ziegler
Point of Contact Phone: (888) 395-4200
Point of Contact Email: lziegler@carerise.com
Two Contract Certification Due By 04/01/2013: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No

Street Address: 200 Corporate Blvd., Suite.201; Lafayette, LA 70508
Mailing Address: Same as street address
Phone: (337) 354-1255
Fax: (337) 262-7425
Web Site: Not Provided
Point of Contact: Kristi Thibodeaux
Point of Contact Phone: (337) 280-2118
Point of Contact Email: Kristi_thibodeaux@schumachergroup.com
Two Contract Certification Due By 07/20/2013: Information Not Received
Disclosures & Findings: None
Subject to FDA-Regulated Reporting Entity Guidance: No