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DSH330236V NewYork-Presbyterian/Brooklyn Methodist (Terminated)
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Main Details
Name
NewYork-Presbyterian/Brooklyn Methodist
Subdivision Name
Ambulatory Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330236V
Medicare Provider Number
330236
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/4/2015
Last Recertification Date
9/11/2020
Termination Date
Termination Reason
10/1/2021
Site closure
Contacts
Authorizing Official
NewYork Presbyterian Brooklyn Methodist Hospital
Michael P. Fagan, Senior VP of Finance
(718) 780-3031
Primary Contact
NewYork Presbyterian Brooklyn Methodist Hospital
Fabienne Vastey, Director of Pharmacy
(718) 780-5575
Addresses
Street Address
343 4th Avenue
Brooklyn, NY 11215-9008
Billing Address
NewYork-Presbyterian/Brooklyn Methodist
506 Sixth Street
Brooklyn, NY 11215
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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