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DSH220035Z NORTH SHORE MEDICAL CENTER (Active)
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Main Details
Name
NORTH SHORE MEDICAL CENTER
Subdivision Name
NORTH SHORE MEDICAL CENTER, INC - SLM Pulm LMV
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220035Z
Medicare Provider Number
220035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/2/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/8/2024
Last Recertification Date
Contacts
Authorizing Official
North Shore Medical Center
Charles E Adams, Executive Director, Finance
(978) 354-4000
Primary Contact
Mass General Brigham - Boston, MA
Rafic Nehme, Enterprise Director
(617) 726-5125
Addresses
Street Address
480 LYNNFIELD ST
LYNN, MA 01904-1419
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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