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DSH220035V NORTH SHORE MEDICAL CENTER (Active)
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Main Details
Name
NORTH SHORE MEDICAL CENTER
Subdivision Name
NSMC Professional Services / MH Highland Hall Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220035V
Medicare Provider Number
220035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/3/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/28/2022
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
North Shore Medical Center
Charles E Adams, Executive Director, Finance
(978) 354-4000
Primary Contact
Mass General Brigham - Boston, MA
Rafic Nehme, Enterprise Director
(617) 726-5125
Addresses
Street Address
55 Highland Avenue
Highland Hall Suites 201, 202
Salem, MA 01970
Billing Address
Norht Shore Medical Center
81 Highland Avenue
Salem, MA 01970
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2015; Terminated 7/1/202; Reinstated 1/1/2023.
11/22/2022
May 2025
May 2025
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