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DSH220074 SOUTHCOAST HOSPITALS GROUP, INC (Active)
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Main Details
Name
SOUTHCOAST HOSPITALS GROUP, INC
Subdivision Name
DBA CHARLTON MEMORIAL HOSPITAL
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220074
Medicare Provider Number
220074
Additional Details
Current Program Status
Active
Registration Date
4/23/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/23/2008
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Southcoast Health
Renee Clark, Exec. Vice President & Chief Operating Officer
(508) 973-5872
Primary Contact
Southcoast Health
Donald Dean, Pharmacy Director
(508) 973-3022
Addresses
Street Address
363 HIGHLAND AVENUE
FALL RIVER, MA 02720
Billing Address
Southcoast Hospitals Group, Inc.
200 Mill Road, Suite 230
Fairhaven, MA 02719
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/13/08 OPA NOTIFIED; 11/21/08 DOCUMENT RECD. TO CONFIRM ELIG. DSH ADJ. %.; 4/1/07 DHS ADJ >11.75%
08/04/2011
12/13/08 OPA NOTIFIED; 11/21/08 DOCUMENT RECD. TO CONFIRM ELIG. DSH ADJ. %.; 4/1/07 DHS ADJ >11.75%
01/21/2010
April 2025
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