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RRC330106-10 NORTH SHORE UNIVERSITY HOSPITAL (Active)
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Main Details
Name
NORTH SHORE UNIVERSITY HOSPITAL
Subdivision Name
NSUH AT SYOSSET - Emergency Room
Type
Rural Referral Center
Rural
No
340B ID
RRC330106-10
Medicare Provider Number
330106
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/23/2024
Last Recertification Date
Contacts
Authorizing Official
Northwell Health
Michele L Cusack, Executive Vice President
(516) 321-6058
Primary Contact
Northwell
Onisis Stefas, VP of Pharmacy Operations
(516) 719-5720
Addresses
Street Address
221 JERICHO TPKE
SYOSSET, NY 11791-4515
Billing Address
NORTH SHORE UNIVERSITY HOSPITAL
300 Community Drive
Manhasset, NY 11030
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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