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DSH220035W NORTH SHORE MEDICAL CENTER (Active)
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Main Details
Name
NORTH SHORE MEDICAL CENTER
Subdivision Name
NSMC MRI Centennial
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220035W
Medicare Provider Number
220035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/3/2016
Last Recertification Date
9/5/2024
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
4 Centennial Dr Suite# 104
Peabody, MA 01960-7929
Billing Address
North Shore Medical Center
81 Highland Avenue
Salem, MA 01970
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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