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DSH220033D BEVERLY HOSPITAL (Active)
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Main Details
Name
BEVERLY HOSPITAL
Subdivision Name
BH WOUND AND HYPERBARIC MEDICAL CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220033D
Medicare Provider Number
220033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/10/2010
Participating Start Date
4/1/2013
Participating Approval Date
3/19/2013
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Beverly Hospital
Gregory Beaumier, CFO - Beverly Hospital
(978) 816-2587
Primary Contact
BILH
Jennifer Rossi, 340B Director of Compliance and Advocacy
(207) 266-9127
Addresses
Street Address
500 CUMMINGS CTR
SUITE 1800
BEVERLY, MA 01915
Billing Address
Beverly Hospital
85 Herrick Street
Beverly, MA 01915
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/19/13 participating 4/1/10 thru 6/30/12, not participating 7/1/12 thru 3/31/13, record reinstated based on new registration submitted and electronically signed by Gary Marlow on 1/14/13; 12/14/09 DOC. RECD. TO CONFIRM DSH ADJ. %.
03/19/2013
12/14/09 DOC. RECD. TO CONFIRM DSH ADJ. %.
03/26/2010
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