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DSH220074CX SOUTHCOAST HOSPITALS GROUP, INC (Active)
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Main Details
Name
SOUTHCOAST HOSPITALS GROUP, INC
Subdivision Name
Fall River Infectious Disease Clinic - Infectious Disease
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220074CX
Medicare Provider Number
220074
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/5/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/9/2024
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Southcoast Health
Renee Clark, Exec. Vice President & Chief Operating Officer
(508) 973-5872
Primary Contact
Southcoast Health
Donald Dean, Pharmacy Director
(508) 973-3022
Addresses
Street Address
235 Hanover St
Fall River, MA 02720
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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