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DSH310083 EAST ORANGE GENERAL HOSPITAL (Terminated)
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Main Details
Name
EAST ORANGE GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310083
Medicare Provider Number
310083
Additional Details
Current Program Status
Terminated
Registration Date
5/6/2008
Participating Start Date
10/1/2004
Participating Approval Date
5/6/2008
Last Recertification Date
8/29/2015
Termination Date
Termination Reason
4/1/2016
For-Profit conversion
Contacts
Authorizing Official
Nicholas Lanza, Chief Financial Officer
(973) 414-3405
Primary Contact
Nicholas Lanza, Chief Financial Officer
(973) 414-3405
Addresses
Street Address
300 CENTRAL AVENUE
EAST ORANGE, NJ 07018
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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04/03/2012 corrected zip (was 07019)
04/03/2012
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