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DSH330028G RICHMOND UNIVERSITY MEDICAL CENTER (Active)
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Main Details
Name
RICHMOND UNIVERSITY MEDICAL CENTER
Subdivision Name
St. GEORGE TREATMENT PROGRAM
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330028G
Medicare Provider Number
330028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/15/2007
Participating Start Date
4/1/2007
Participating Approval Date
3/16/2007
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Richmond Medical Center
David Stephen Murray, Chief Financial Officer
(718) 818-3295
Primary Contact
Richmond Medical Center
Nicholas Galeno, 340B Compliance Manager
(718) 818-2077
Addresses
Street Address
1130 South Ave
STATEN ISLAND, NY 10314
Billing Address
Richmond University Medical Center
355 Bard Ave
Staten Island, NY 10310
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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