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DSH080004A BAYHEALTH MEDICAL CENTER INC. (Terminated)
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Main Details
Name
BAYHEALTH MEDICAL CENTER INC.
Subdivision Name
KENT GENERAL HOSPITAL HOME HEALTH
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH080004A
Medicare Provider Number
080004
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
3/3/2009
Participating Start Date
4/1/2009
Participating Approval Date
3/6/2009
Last Recertification Date
8/30/2016
Termination Date
Termination Reason
1/1/2018
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Bayhealth Medical Center
Michael James Tretina, CFO
(302) 744-7162
Primary Contact
Bayhealth Medical Center
Alex Zarow, Pharmacy Director
(302) 744-6753
Addresses
Street Address
560 South Governors Ave.
DOVER, DE 19901-3523
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/27/12 remove medicaid number 2/26/2010-DOC. RECD. TO CONFIRM ELIG. DSH ADJ%; 2/26/09 DOC RECD TO CONFIRM ELIG DSH ADJ%
02/27/2012
2/26/2010-DOC. RECD. TO CONFIRM ELIG. DSH ADJ%; 2/26/09 DOC RECD TO CONFIRM ELIG DSH ADJ%
03/06/2009
2/26/2010-DOC. RECD. TO CONFIRM ELIG. DSH ADJ%; 2/26/09 DOC RECD TO CONFIRM ELIG DSH ADJ%
03/06/2009
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