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DSH310064AH ATLANTICARE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
ATLANTICARE REGIONAL MEDICAL CENTER
Subdivision Name
SCC - Galloway
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310064AH
Medicare Provider Number
310064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/11/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/29/2012
Last Recertification Date
11/8/2017
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
AtlantiCare
Hak Kim, Chief Financial Officer
(609) 569-7031
Primary Contact
armc
rosemary nuzzo, Director, Finance
(609) 383-2114
Addresses
Street Address
54 W. Jimmie Leeds Road
suite 8
Galloway, NJ 08205-9401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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