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DSH330194 MAIMONIDES MEDICAL CENTER (Active)
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Main Details
Name
MAIMONIDES MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330194
Medicare Provider Number
330194
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
8/30/2024
Contacts
Authorizing Official
Maimonides Medical Center
John Marshall, EVP MedAffair/Chair MedOfficer
(718) 283-8313
Primary Contact
Maimonides Medical Center
Yevgenia Bukher, Assistant Director, Pharmacy
(718) 283-7232
Addresses
Street Address
4802 TENTH AVE.
BROOKLYN, NY 11219
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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