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DSH330234H WESTCHESTER MEDICAL CENTER (Terminated)
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Main Details
Name
WESTCHESTER MEDICAL CENTER
Subdivision Name
Speech Pathology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330234H
Medicare Provider Number
330234
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/9/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/6/2013
Last Recertification Date
8/28/2018
Termination Date
Termination Reason
4/1/2019
Other
Contacts
Authorizing Official
Westchester Medical Center
Anthony Costello, COO
(914) 493-7028
Primary Contact
Westchester Medical Center
Varghese Thankachen, Network Director of Pharmacy Business Operations
(914) 493-7205
Addresses
Street Address
19 Bradhurst Ave.
Hawthorne, NY 10532
Billing Address
WESTCHESTER MEDICAL CENTER
100 Woods Road
VALHALLA, NY 10595
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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