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DSH310029 Virtua Our Lady Of Lourdes Hospital (Active)
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Main Details
Name
Virtua Our Lady Of Lourdes Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310029
Medicare Provider Number
310029
Additional Details
Current Program Status
Active
Registration Date
1/30/2007
Participating Start Date
7/1/2009
Participating Approval Date
6/14/2009
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Virtua Our Lady of Lourdes
Lisa Ferraro, President Virtua Lourdes, SVP Virtua Health
(856) 886-5372
Primary Contact
Virtua Our Lady of Lourdes
William Haigh, Director of Pharmacy Operations
(856) 886-6369
Addresses
Street Address
1600 HADDON AVENUE
CAMDEN, NJ 08103
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/1/09 REINSTATED ORIG PART FROM 4/1/07 TO 9/30/07, NOT ELIG FROM 10/1/07 TO 6/30/09
06/14/2009
May 2025
May 2025
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