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DSH310064AZ ATLANTICARE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
ATLANTICARE REGIONAL MEDICAL CENTER
Subdivision Name
Enhanced Care Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310064AZ
Medicare Provider Number
310064
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/28/2015
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 AVE
SUITE 2300-2500
ATLANTIC CITY, NJ 08401-7022
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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