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DSH220086DX BETH ISRAEL DEACONESS MEDICAL CENTER (Active)
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Main Details
Name
BETH ISRAEL DEACONESS MEDICAL CENTER
Subdivision Name
BIDMC Winchester HemOnc
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH220086DX
Medicare Provider Number
220086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/2/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/8/2024
Last Recertification Date
Contacts
Authorizing Official
BIDMC
Matthew Larkin, Chief Operating Officer
(617) 677-7144
Primary Contact
BILH
Jennifer Rossi, 340B Director of Compliance and Advocacy
(207) 266-9127
Addresses
Street Address
620 Washington Street
2nd floor
Winchester, MA 01890
Billing Address
BIDMC
330 Brookline Ave
Boston, ME 02115
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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