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DSH330233 BROOKDALE HOSPITAL MEDICAL CENTER (Active)
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Main Details
Name
BROOKDALE HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330233
Medicare Provider Number
330233
Additional Details
Current Program Status
Active
Registration Date
5/6/2008
Participating Start Date
10/1/2004
Participating Approval Date
5/6/2008
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Brookdale Hospital Medical Center
Diana Sullivan, VP
(718) 240-7449
Primary Contact
Brookdale Hospital
Johnny Ha, Director of Pharmacy
(718) 240-5994
Addresses
Street Address
ONE BROOKDALE PLAZA
BROOKLYN, NY 11212
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/22/11 UPDATED PHYS ADD (WAS ONE BROOKDALE PLAZA), ADDED BILL-TO ADD
07/22/2011
April 2025
April 2025
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