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DSH310086T KENNEDY MEMORIAL HOSPITAL-UMC (Terminated)
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Main Details
Name
KENNEDY MEMORIAL HOSPITAL-UMC
Subdivision Name
KENNEDY MEMORIAL HOSPITAL / Diagnostic Radiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310086T
Medicare Provider Number
310086
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/11/2016
Last Recertification Date
9/5/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Kennedy Memorial Hospital - UMC
Stephen V DeStefano, Vice President Finance
(215) 587-3332
Primary Contact
Jefferson Health
Dustin Ottemiller, VP, Finance
(215) 503-5219
Addresses
Street Address
435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE, NJ 08012-2453
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/11/16 CE reinstated effective 4/1/16, was participating from 10/1/15 to 12/31/15, not participating from 1/1/2016 to 3/31/16
03/11/2016
April 2025
April 2025
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