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DSH220024C HOLYOKE MEDICAL CENTER (Terminated)
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Main Details
Name
HOLYOKE MEDICAL CENTER
Subdivision Name
HMC ORTHOPEDIC SURGEONS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220024C
Medicare Provider Number
220024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/2/2016
Last Recertification Date
8/27/2019
Termination Date
Termination Reason
7/1/2020
Other
Contacts
Authorizing Official
Holyoke Medical Center
SPIROS HATIRAS, CEO
(413) 534-2667
Primary Contact
Holyoke Medical Center
Paul J Barrett, Director of Pharmacy
(413) 534-2757
Addresses
Street Address
10 HOSPITAL DR
HOLYOKE, MA 01040-6643
Billing Address
Holyoke Medical Center
575 Beech St
Holyoke, MA 01040
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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