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DSH330215B Rome Memorial Hospital, Inc. (Active)
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Main Details
Name
Rome Memorial Hospital, Inc.
Subdivision Name
Boonville Family Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330215B
Medicare Provider Number
330215
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/22/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/2/2013
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Rome Health
Nathan Smith, AVP Finance
(315) 338-7597
Primary Contact
Rome Health
Tabatha Cingranelli, Controller
(315) 338-7275
Addresses
Street Address
13407 State Route 12
Boonville, NY 13309
Billing Address
Rome Memorial Hospital, Inc.
1500 North James Street
Rome, NY 13440
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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