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DSH310064AY ATLANTICARE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
ATLANTICARE REGIONAL MEDICAL CENTER
Subdivision Name
Special Care Center / Comprehensive Wellness Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310064AY
Medicare Provider Number
310064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/11/2015
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
AtlantiCare
Hak Kim, Chief Financial Officer
(609) 569-7031
Primary Contact
AtlantiCare Regional Medical Center
Timothy Joseph Ryan, Reimbursement Manager
(609) 383-2805
Addresses
Street Address
1401 ATLANTIC AVENUE
SUITE 2300
ATLANTIC CITY, NJ 08401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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