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DSH310014C THE COOPER HEALTH SYSTEM DBA COOPER UNIVERSITY HOSPITAL (Active)
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Main Details
Name
THE COOPER HEALTH SYSTEM DBA COOPER UNIVERSITY HOSPITAL
Subdivision Name
COOPER DIGESTIVE HEALTH INSTITUTE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310014C
Medicare Provider Number
310014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/10/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/14/2009
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Cooper University Hospital
Brian M Reilly, CFO
(856) 342-2443
Primary Contact
Cooper University Hospital
Tricia Anne Ligato, Director Financial Operations
(856) 382-6519
Addresses
Street Address
501 FELLOWSHIP ROAD
SUITE 102
MT. LAUREL, NJ 08054
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/17/10 SUITE # ADDED
06/10/2009
April 2025
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