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DSH100039B BROWARD HEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
BROWARD HEALTH MEDICAL CENTER
Subdivision Name
SEVENTH AVENUE FAMILY HEALTH CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100039B
Medicare Provider Number
100039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/3/2008
Participating Start Date
7/1/2008
Participating Approval Date
6/4/2008
Last Recertification Date
8/19/2019
Termination Date
Termination Reason
10/1/2020
Other
Contacts
Authorizing Official
North Broward Hospital District dba Broward Health Medical Center
Laura Danielle Thomas, CFO
(954) 767-5471
Primary Contact
North Broward Hospital District d/b/a Broward Health
Bernice Shorter-Meares, Regional Pharmacy Manager
(954) 759-6651
Addresses
Street Address
200 NORTHWEST 7TH AVENUE
FT. LAUDERDALE, FL 33311
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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