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DSH330055T NEWYORK-PRESBYTERIAN / QUEENS (Terminated)
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Main Details
Name
NEWYORK-PRESBYTERIAN / QUEENS
Subdivision Name
Employee Health Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330055T
Medicare Provider Number
330055
Outpatient Facility Provider Number
330055
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/3/2013
Last Recertification Date
11/27/2017
Termination Date
Termination Reason
7/1/2018
Other
Contacts
Authorizing Official
NY Presbyterian/Queens
Kevin Ward, Senior VP FOR FINANCE
(718) 670-1476
Primary Contact
NewYork-Presbyterian-Queens
Alexander Melchert, Director of Pharmacy
(718) 670-1545
Addresses
Street Address
139-09 58th Street
Flushing, NY 11355
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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