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DSH310019M St. Joseph’s University Medical Center (Terminated)
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Main Details
Name
St. Joseph’s University Medical Center
Subdivision Name
St. Joseph's Cardiovascular Center - Nutley
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310019M
Medicare Provider Number
310019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/9/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/17/2013
Last Recertification Date
8/15/2023
Termination Date
Termination Reason
1/1/2024
Site closure
Contacts
Authorizing Official
St. Joseph's University Medical Center
Kevin Slavin, President and CEO
(973) 754-2010
Primary Contact
St. Joseph’s University Medical Center
Alexander Lee, 340B Program Manager
(973) 754-4823
Addresses
Street Address
181 Franklin Avenue
Suite 301
Nutley, NJ 07110
Billing Address
St. Joseph's Hospital and Medical Center
703 Main Street
Paterson, NJ 07503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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