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DSH220001 HealthAlliance-Clinton Hospital (Active)
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Main Details
Name
HealthAlliance-Clinton Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220001
Medicare Provider Number
220001
Additional Details
Current Program Status
Active
Registration Date
5/2/2008
Participating Start Date
10/1/2004
Participating Approval Date
5/2/2008
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Marlborough Hospital
Steven McCue, Chief Financial Officer
(508) 486-5804
Primary Contact
UMass Memorial HealthAlliance-Clinton Hospital
Richard Bautz, Director of Pharmacy
(774) 437-3741
Addresses
Street Address
60 HOSPITAL ROAD
LEOMINSTER, MA 01453
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/30/2010- DOC RECD TO CONFIRM ELIG DSH ADJ %; 8/31/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
05/29/2012
7/30/2010- DOC RECD TO CONFIRM ELIG DSH ADJ %; 8/31/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
10/20/2009
7/30/2010- DOC RECD TO CONFIRM ELIG DSH ADJ %; 8/31/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
05/02/2008
April 2025
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