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DSH330202A KINGS COUNTY HOSPITAL CENTER (NYCHHC) (Terminated)
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Main Details
Name
KINGS COUNTY HOSPITAL CENTER (NYCHHC)
Subdivision Name
Bedford Stuyvesant Alchoholism Treatment Ctr - Kings (NYCHHC)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330202A
Medicare Provider Number
330202
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/11/2014
Last Recertification Date
8/28/2019
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
New York City Health and Hospitals
Paul Albertson, Vice President
(212) 748-2256
Primary Contact
New York City Health and Hospitals
Min Than, Assistant Vice President
(212) 442-3854
Addresses
Street Address
722 Myrtle Avenue
Brooklyn, NY 11205
Billing Address
Kings County Hospital Center
451 Clarkson Avenue
Brooklyn, NY 12203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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