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DSH080004D BAYHEALTH MEDICAL CENTER INC. (Terminated)
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Main Details
Name
BAYHEALTH MEDICAL CENTER INC.
Subdivision Name
KENT GENERAL HOSPITAL CANCER CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH080004D
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
8/7/2015
Termination Date
Termination Reason
4/1/2016
Other
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
640 South State Street
Dover, DE 19901-3530
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/27/12 update address from 793 SOUTH QUEEN STREET DOVER, DE 19904-3568 and 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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