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DSH220063D THE LOWELL GENERAL HOSPITAL (Active)
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Main Details
Name
THE LOWELL GENERAL HOSPITAL
Subdivision Name
Saints Campus / TB/Immunization Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220063D
Medicare Provider Number
220063
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2016
Participating Start Date
10/1/2016
Participating Approval Date
9/14/2016
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Tufts Medicine Lowell General Hospital
Keary Allicon, Sr. Director of Finance
(978) 937-6353
Primary Contact
Lowell General
Eric Musial, Director of Pharmacy Services
(978) 937-6416
Addresses
Street Address
1 Hospital Drive
Lowell, MA 01852
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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