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DSH220086 BETH ISRAEL DEACONESS MEDICAL CENTER (Active)
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Main Details
Name
BETH ISRAEL DEACONESS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH220086
Medicare Provider Number
220086
Additional Details
Current Program Status
Active
Registration Date
9/13/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/21/2009
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
BIDMC
Matthew Larkin, Chief Operating Officer
(617) 677-7144
Primary Contact
BILH
Jennifer Rossi, 340B Director of Compliance and Advocacy
(207) 266-9127
Addresses
Street Address
330 Brookline Ave
BOSTON, MA 02215
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/19/2009- OPA NOTIFIED AUG. 28. 2009- DOC. RECD. TO CONFIRM DSH ADJ. %.-09/23/10 ADDED SHIP TO ADDR.
09/23/2010
May 2025
May 2025
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