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DSH330028A RICHMOND UNIVERSITY MEDICAL CENTER (Terminated)
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Main Details
Name
RICHMOND UNIVERSITY MEDICAL CENTER
Subdivision Name
BAYLEY SETON
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330028A
Medicare Provider Number
330028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/16/2005
Participating Start Date
11/17/2005
Participating Approval Date
11/17/2005
Last Recertification Date
8/15/2016
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
Richmond University Medical Center
Joseph Saporito, CFO
(718) 818-3295
Primary Contact
Richmond University Medical Center
Angela Gilbride, Director of Pharmacy
(718) 818-2077
Addresses
Street Address
75 VANDERBILT AVENUE
STATEN ISLAND, NY 10304
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/9/07 - NAME CHANGE FROM SISTERS OF CHARITY DBA BAYLEY SETON HOSPITAL
05/17/2007
May 2025
May 2025
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