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DSH310039B RARITAN BAY MEDICAL CENTER (Terminated)
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Main Details
Name
RARITAN BAY MEDICAL CENTER
Subdivision Name
Medical Arts Building - Radiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310039B
Medicare Provider Number
310039
Outpatient Facility Provider Number
310039
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2014
Participating Start Date
4/1/2014
Participating Approval Date
1/31/2014
Last Recertification Date
9/8/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Raritan Bay Medical Center
THOMAS G. SHANAHAN, Executive VP, COO
(732) 324-5401
Primary Contact
Kevin M. Field, Sr. Director, Reimbursement & Financial Technology
(732) 293-2311
Addresses
Street Address
Three Hospital Plaza
Basement Level
Old Bridge, NJ 08857
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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