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DSH330056B THE BROOKLYN HOSPITAL CENTER (Terminated)
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Main Details
Name
THE BROOKLYN HOSPITAL CENTER
Subdivision Name
PATH CENTER, ADULTS & PEDIATRICS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330056B
Medicare Provider Number
330056
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/5/2008
Participating Start Date
9/5/2008
Participating Approval Date
9/5/2008
Last Recertification Date
9/2/2020
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
The Brooklyn Hospital Center
Donald P. Minarcik, VP Revenue Enhancement
(718) 488-3775
Primary Contact
The Brooklyn Hospital Center
Kathleen Minlionica, Director of Pharmacy, Per diem
(718) 250-8220
Addresses
Street Address
2244 CHURCH AVENUE
BROOKLYN, NY 11226
Billing Address
The Brooklyn Hospital Center
121 DeKalb Avenue
Brooklyn, NY 11201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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