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DSH330395B EPISCOPAL HEALTH SERVICES INC (Active)
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Main Details
Name
EPISCOPAL HEALTH SERVICES INC
Subdivision Name
Community Mental Health Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330395B
Medicare Provider Number
330395
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/24/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
St. John's Episcopal
Donald Morrish, Chief Executive Officer
(718) 869-7321
Primary Contact
St.John's Episcopal
Karen Muir, Chief Pharmacy Officer
(718) 869-7180
Addresses
Street Address
521 Beach 20th Street
Far Rockaway, NY 11691
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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