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DSH310064AN ATLANTICARE REGIONAL MEDICAL CENTER (Active)
Main Details
Name
ATLANTICARE REGIONAL MEDICAL CENTER
Subdivision Name
HEALTHPLEX Clinic Service - Ambulatory Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310064AN
Medicare Provider Number
310064
Outpatient Facility Provider Number
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
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
8/15/2023
Addresses
Street Address
1401 Atlantic Avenue
Suite 2800
Atlantic City, NJ 08401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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