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DSH390329E EINSTEIN MEDICAL CENTER MONTGOMERY (Approved)
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Main Details
Name
EINSTEIN MEDICAL CENTER MONTGOMERY
Subdivision Name
Sleep Lab
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390329E
Medicare Provider Number
390329
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/15/2025
Participating Start Date
7/1/2025
Participating Approval Date
6/2/2025
Last Recertification Date
Contacts
Authorizing Official
Jefferson Health
CARRIE FREY, Director of Finance
(215) 612-4313
Primary Contact
Jefferson Health
Dustin Ottemiller, VP, Finance
(215) 503-5219
Addresses
Street Address
633 W Germantown Pike
Suite 101
Plymouth Meeting, PA 19462
Billing Address
Einstein Medical Center Montgomery
559 Germantown Pike
East Norriton, PA 19403
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2016; Terminated 1/1/2025; Reinstated 7/1/2025.
05/30/2025
June 2025
June 2025
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