| Details | Last Recertification Date | Update | Recertification | 2/13/2024 2:28:54 PM | 2/13/2025 11:08:39 AM | 2/13/2025 11:08 AM |
| Details | Last Recertification Date | Update | Recertification | 1/30/2023 6:14:25 PM | 2/13/2024 2:28:54 PM | 2/13/2024 2:28 PM |
| Details | Last Recertification Date | Update | Recertification | 1/31/2022 11:33:32 AM | 1/30/2023 6:14:25 PM | 1/30/2023 6:14 PM |
| Details | Last Recertification Date | Update | Recertification | 2/3/2021 1:05:55 PM | 1/31/2022 11:33:32 AM | 1/31/2022 11:33 AM |
| Addresses | Shipping Address | Delete | Change Request | The Floating Hospital Pharmacy
25-01 Queens Plaza N
Long Island CIty, NY 11101 | | 7/29/2021 7:12 AM |
| Addresses | Shipping Address | Delete | Change Request | The Floating Hospital
41-40 27th ST
Long Island City, NY 11101 | | 7/29/2021 7:12 AM |
| Addresses | Main Address | Update | Change Request |
4140 27th St
Long Island City, NY 11101-3825 |
2101 41st Ave
Long Island City, NY 11101-4801 | 7/29/2021 7:12 AM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1306954631 ( ) | | 2/3/2021 1:05 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1306954631 | 2/3/2021 1:05 PM |
| Medicaid Billing | NPI: State | Insert | Recertification | | NY | 2/3/2021 1:05 PM |
| Contacts | Primary Contact | Update | Recertification | Stoddard, Lois L
Director of Finance
The Floating Hospital
7187842240-124 | Barnes, Brandon Dante
Pharmacy Manager
The Floating Hospital
9172702956 | 2/3/2021 1:05 PM |
| Details | Last Recertification Date | Update | Recertification | 1/27/2020 10:48:34 AM | 2/3/2021 1:05:55 PM | 2/3/2021 1:05 PM |
| Details | Last Recertification Date | Update | Recertification | 1/31/2019 11:35:02 AM | 1/27/2020 10:48:34 AM | 1/27/2020 10:48 AM |
| Addresses | Shipping Address | Insert | Change Request | | The Floating Hospital
41-40 27th ST
Long Island City, NY 11101 | 10/21/2019 10:25 AM |
| Addresses | Shipping Address | Insert | Change Request | | The Floating Hospital Pharmacy
25-01 Queens Plaza N
Long Island CIty, NY 11101 | 10/21/2019 10:25 AM |
| Contacts | Primary Contact | Update | Change Request | Meton, Luca
Executive Assistant
The Floating Hospital
7187842240-209 | Stoddard, Lois L
Director of Finance
The Floating Hospital
7187842240-124 | 6/14/2019 7:41 AM |
| Details | Last Recertification Date | Update | Recertification | 2/15/2018 9:34:32 AM | 1/31/2019 11:35:02 AM | 1/31/2019 11:35 AM |
| Contacts | Primary Contact | Update | Recertification | Andre, Shani
VP/CMO
The Floating Hospital
7187842240-140 | Meton, Luca
Executive Assistant
The Floating Hospital
7187842240-209 | 2/15/2018 9:34 AM |
| Details | Last Recertification Date | Update | Recertification | 2/7/2017 12:00:00 AM | 2/15/2018 9:34:32 AM | 2/15/2018 9:34 AM |
| Contacts | Authorizing Official | Update | | Andre, Shani
VP/CMO
7187842240-140 | Andre, Shani
VP/CMO
The Floating Hospital
7187842240-140 | 2/12/2018 10:10 AM |
| Contacts | Primary Contact | Update | | Andre, Shani
VP/CMO
7187842240-140 | Andre, Shani
VP/CMO
The Floating Hospital
7187842240-140 | 2/12/2018 10:10 AM |
| Contacts | Authorizing Official | Insert | | | Andre, Shani
VP/CMO
7187842240-140 | 4/25/2017 6:25 PM |
| Contacts | Primary Contact | Update | | DEVILLE, DEETTE
MEDICATION/VACCINE COORDINATOR
6463729007 | Andre, Shani
VP/CMO
7187842240-140 | 4/25/2017 6:25 PM |
| Addresses | Main Address | Insert | | |
4140 27th St
Long Island City, NY 11101-3825 | 2/7/2017 1:44 PM |
| Details | Last Recertification Date | Update | | 3/1/2016 12:00:00 AM | 2/7/2017 12:00:00 AM | 2/7/2017 1:44 PM |
| Details | Last Recertification Date | Update | | 3/3/2015 12:00:00 AM | 3/1/2016 12:00:00 AM | 3/1/2016 1:34 PM |
| Addresses | Billing Address | Insert | | | THE FLOATING HOSPITAL
PO BOX 8397
LONG ISLAND CITY, NY 11101 | 1/19/2016 5:15 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 10/1/2015 7:41 AM |
| Medicaid Billing | Medicaid: Number | Insert | | | 00245038 | 10/1/2015 7:41 AM |
| Medicaid Billing | Medicaid: State | Insert | | | NY | 10/1/2015 7:41 AM |
| Medicaid Billing | NPI: Number | Insert | | | 1306954631 | 10/1/2015 7:41 AM |
| Details | Last Recertification Date | Update | | 2/17/2014 12:00:00 AM | 3/3/2015 12:00:00 AM | 3/3/2015 8:59 AM |
| Details | Entity Name | Update | | THE FLOATING HOSPITAL | FLOATING HOSPITAL INCORPORATED (THE) | 3/31/2014 4:25 PM |
| Details | Entity Subname | Update | | | THE FLOATING HOSPITAL | 3/31/2014 4:25 PM |
| Details | Last Recertification Date | Update | | 4/1/2013 12:00:00 AM | 2/17/2014 12:00:00 AM | 2/17/2014 10:56 AM |
| Details | Last Recertification Date | Update | | | 4/1/2013 12:00:00 AM | 2/6/2013 10:15 AM |
| Contacts | Primary Contact | Insert | | | DEVILLE, DEETTE
MEDICATION/VACCINE COORDINATOR
6463729007 | 11/1/2012 2:58 PM |
| Details | Comments Public | Insert | | | Address is not showing in EHB as approved site, contact the BPHC project officer to submit a change in scope. OPA will not make the change until verification can be made.
Address is not in EHB as an approved site, contact BPHC project officer to submit a change of scope.
6/23/10 ADDED BILL TO; 2/24/10 UPDATED PHYS ADD (WAS 90 WILLIAM ST, #1402, NY, NY 10038) | 11/1/2012 2:58 PM |
| Details | Comments Public | Insert | | | Address is not in EHB as an approved site, contact BPHC project officer to submit a change of scope.
6/23/10 ADDED BILL TO; 2/24/10 UPDATED PHYS ADD (WAS 90 WILLIAM ST, #1402, NY, NY 10038) | 9/28/2012 12:02 PM |
| Details | Last Recertification Date | Insert | | | | 6/23/2010 5:08 PM |
| Details | Grant Number | Insert | | | H80CS00268 | 6/23/2010 5:08 PM |
| Details | 340B ID | Insert | | | CH025500 | 6/23/2010 5:08 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 6/23/2010 5:08 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 6/23/2010 5:08 PM |
| Details | Medicare Provider Number | Insert | | | | 6/23/2010 5:08 PM |
| Details | Entity Name | Insert | | | THE FLOATING HOSPITAL | 6/23/2010 5:08 PM |
| Details | Program Code | Insert | | | CH | 6/23/2010 5:08 PM |
| Details | Entity Subname | Insert | | | | 6/23/2010 5:08 PM |
| Dates | Participating Approval Date | Insert | | | 8/22/2005 12:00:00 AM | 6/23/2010 5:08 PM |
| Details | State | Insert | | | Active | 6/23/2010 5:08 PM |
| Dates | Registration Date | Insert | | | 8/22/2005 12:00:00 AM | 6/23/2010 5:08 PM |
| Dates | Signed By Date | Insert | | | 6/13/2005 12:00:00 AM | 6/23/2010 5:08 PM |
| Dates | Start Date | Insert | | | 9/9/2005 12:00:00 AM | 6/23/2010 5:08 PM |
| Terminations | Termination Comments | Insert | | | | 6/23/2010 5:08 PM |
| Terminations | Termination Date | Insert | | | | 6/23/2010 5:08 PM |
| Terminations | Termination Effective Date | Insert | | | | 6/23/2010 5:08 PM |
| Terminations | Termination Reason | Insert | | | | 6/23/2010 5:08 PM |
| Details | Comments Public | Insert | | | 6/23/10 ADDED BILL TO; 2/24/10 UPDATED PHYS ADD (WAS 90 WILLIAM ST, #1402, NY, NY 10038) | 6/23/2010 5:08 PM |