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DSH390329A EINSTEIN MEDICAL CENTER MONTGOMERY (Terminated)
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Main Details
Name
EINSTEIN MEDICAL CENTER MONTGOMERY
Subdivision Name
Wound Care Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390329A
Medicare Provider Number
390329
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/5/2016
Last Recertification Date
8/16/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Jefferson Health
Beth Duffy, Sr. VP Administrative Services
(215) 527-7657
Primary Contact
Jefferson Health
Dustin Ottemiller, VP, Finance
(215) 503-5219
Addresses
Street Address
633 W Germantown Pike
Suite 200
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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