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DSH100276 Broward Health Coral Springs (Active)
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Main Details
Name
Broward Health Coral Springs
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100276
Medicare Provider Number
100276
Additional Details
Current Program Status
Active
Registration Date
9/5/2007
Participating Start Date
10/1/2007
Participating Approval Date
9/6/2007
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Broward Health Coral Springs
Modesto Gato, Chief Financial Officer
(786) 273-6188
Primary Contact
North Broward Hospital District dba Broward Health
Dave A Lacknauth, Executive Director of Pharmacy Services
(954) 473-7078
Addresses
Street Address
3000 CORAL HILLS DRIVE
CORAL SPRINGS, FL 33065
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/9/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
12/14/2009
April 2025
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