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DSH220086E BETH ISRAEL DEACONESS MEDICAL CENTER (Active)
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Main Details
Name
BETH ISRAEL DEACONESS MEDICAL CENTER
Subdivision Name
ARNOLD PAIN MANAGEMENT CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH220086E
Medicare Provider Number
220086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
9/2/2010
Participating Start Date
10/1/2010
Participating Approval Date
9/16/2010
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
ONE BROOKLINE PLACE
BROOKLINE, MA 02445
Billing Address
Beth Israel Deaconess Medical Center
330 Brookline Ave.
Boston, MA 02215
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. %.
09/16/2010
April 2025
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