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DSH330261 PHELPS MEMORIAL HOSPITAL CENTER (Active)
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Main Details
Name
PHELPS MEMORIAL HOSPITAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330261
Medicare Provider Number
330261
Additional Details
Current Program Status
Active
Registration Date
8/26/2008
Participating Start Date
9/2/2008
Participating Approval Date
9/2/2008
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Northwell Health
Michele L Cusack, Executive Vice President
(516) 321-6058
Primary Contact
Northwell
Onisis Stefas, VP of Pharmacy Operations
(516) 719-5720
Addresses
Street Address
701 NORTH BROADWAY
SLEEPY HOLLOW, NY 10591
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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