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DSH310064AS ATLANTICARE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
ATLANTICARE REGIONAL MEDICAL CENTER
Subdivision Name
Infectious Disease Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310064AS
Medicare Provider Number
310064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/11/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/29/2012
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
AtlantiCare
Hak Kim, Chief Financial Officer
(609) 569-7031
Primary Contact
AtlantiCare Regional Medical Center
Timothy Joseph Ryan, Reimbursement Manager
(609) 383-2805
Addresses
Street Address
1401 Atlantic Avenue
Suite 2200
Atlantic City, NJ 08401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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