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DSH310064AJ ATLANTICARE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
ATLANTICARE REGIONAL MEDICAL CENTER
Subdivision Name
Specialty Care Clinic (SCC)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310064AJ
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
8/27/2019
Termination Date
Termination Reason
7/1/2020
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
AtlantiCare
Hak Kim, Chief Financial Officer
(609) 569-7031
Primary Contact
AtlantiCare Regional Medical Center
Christin Fenton, Reimbursement Manager
(609) 677-7171
Addresses
Street Address
1401 Atlantic Ave.
Suite 2500
Atlantic City, NJ 08401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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