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DSH330208 ST JOHNS RIVERSIDE HOSPITAL (Active)
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Main Details
Name
ST JOHNS RIVERSIDE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330208
Medicare Provider Number
330208
Additional Details
Current Program Status
Active
Registration Date
4/21/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/21/2008
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
St. John's Riverside Hospital
Michael A DiGiorno, Chief Operating Officer
(914) 798-8972
Primary Contact
St John's Riverside Hospital
JANINE O'DONNELL, AVP of Pharmacy and Medical Operations
(914) 964-4827
Addresses
Street Address
967 NORTH BROADWAY
YONKERS, NY 10701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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