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DSH310092 CAPITAL HEALTH SYSTEM - FULD (Active)
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Main Details
Name
CAPITAL HEALTH SYSTEM - FULD
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310092
Medicare Provider Number
310092
Additional Details
Current Program Status
Active
Registration Date
8/29/2007
Participating Start Date
10/1/2012
Participating Approval Date
9/27/2012
Last Recertification Date
9/16/2024
Contacts
Authorizing Official
Capital Health System., Inc.
Laura McGuire, CCO
(609) 394-6783
Primary Contact
Capital Health System, Inc.
Kenneth John Bevenour, Director of Pharmacy
(609) 815-7657
Addresses
Street Address
750 BRUNSWICK AVENUE
TRENTON, NJ 08638
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/27/12 participating 1/1/05 thru 6/30/2011, not participating 7/1/11 thru 9/30/12
09/27/2012
May 2025
May 2025
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