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DSH390115AE Jefferson Health Northeast (Active)
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Main Details
Name
Jefferson Health Northeast
Subdivision Name
Bucks Campus Electrocardiology - - Cardiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390115AE
Medicare Provider Number
390115
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/27/2025
Last Recertification Date
Contacts
Authorizing Official
Jefferson Health
CARRIE FREY, Director of Finance
(215) 612-4313
Primary Contact
Jefferson Health
Dustin Ottemiller, VP, Finance
(215) 503-5219
Addresses
Street Address
380 N. Oxford Valley Road
Langhorne, PA 19124
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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