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DSH330231E QUEENS HOSPITAL CENTER (NYCHHC) (Terminated)
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Main Details
Name
QUEENS HOSPITAL CENTER (NYCHHC)
Subdivision Name
Queens Geriatric Clinic Primary Care Clinic South Queens
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330231E
Medicare Provider Number
330231
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/21/2014
Last Recertification Date
9/10/2018
Termination Date
Termination Reason
1/1/2019
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
New York City Health and Hospitals
Paul Albertson, Vice President
(212) 748-2256
Primary Contact
New York City Health + Hospitals
Danielle Sestito, Senior Director, 340B Operations
(212) 442-3892
Addresses
Street Address
114-02 Guy Brewer Blvd
Jamaica, NY 11434
Billing Address
Queens Hospital Center
82-68 164th Street
Jamaica, NY 11432
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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