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DSH100039 BROWARD HEALTH MEDICAL CENTER (Active)
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Main Details
Name
BROWARD HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100039
Medicare Provider Number
100039
Additional Details
Current Program Status
Active
Registration Date
4/14/2008
Participating Start Date
7/1/2003
Participating Approval Date
4/14/2008
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Broward Health Medical Center
Donald Jaffee, Chief Financial Officer
(954) 355-5319
Primary Contact
North Broward Hospital District dba Broward Health
Dave A Lacknauth, Executive Director of Pharmacy Services
(954) 473-7078
Addresses
Street Address
1600 SOUTH ANDREWS AVE.
FORT LAUDERDALE, FL 33316
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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