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DSH330196B CONEY ISLAND HOSPITAL (NYCHHC) (Terminated)
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Main Details
Name
CONEY ISLAND HOSPITAL (NYCHHC)
Subdivision Name
STAPLETON Child Health Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330196B
Medicare Provider Number
330196
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/16/2008
Participating Start Date
1/1/2009
Participating Approval Date
12/16/2008
Last Recertification Date
9/10/2018
Termination Date
Termination Reason
1/1/2019
Site closure
Contacts
Authorizing Official
New York City Health and Hospitals
Paul Albertson, Vice President
(212) 748-2256
Primary Contact
New York City Health + Hospitals
Danielle Sestito, Senior Director, 340B Operations
(212) 442-3892
Addresses
Street Address
111 CANAL STREET
STATEN ISLAND, NY 10304
Billing Address
Coney Island Hospital
2601 Ocean Parkway
Brooklyn, NY 11235
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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