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DSH310019B St. Joseph's Hospital and Medical Center (Terminated)
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Main Details
Name
St. Joseph's Hospital and Medical Center
Subdivision Name
DePaul Ambulatory Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310019B
Medicare Provider Number
310019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2013
Participating Start Date
1/15/2013
Participating Approval Date
1/15/2013
Last Recertification Date
8/10/2015
Termination Date
Termination Reason
7/1/2016
Site closure
Contacts
Authorizing Official
St. Joseph's Hospital & Medical Center
Kevin Slavin, President and CEO
(973) 754-2002 Ext: 9737542010
Primary Contact
David Alexander, CFO
(973) 754-2023
Addresses
Street Address
11 Getty Avenue
275 Hospital Plaza Bldg
Paterson, NJ 07503
Billing Address
St. Joseph's Hospital and Medical Center
703 Main Street
Paterson, NJ 07503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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