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DSH070022CT YALE NEW HAVEN HOSPITAL (Terminated)
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Main Details
Name
YALE NEW HAVEN HOSPITAL
Subdivision Name
SRC Electroconvulsive Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070022CT
Medicare Provider Number
070022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2016
Participating Start Date
1/1/2017
Participating Approval Date
12/15/2016
Last Recertification Date
9/10/2021
Termination Date
Termination Reason
4/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Yale New Haven Health System
Mary G Messina, Director, Regulatory Reimbursement YNHHS
(203) 688-8543
Primary Contact
Yale New Haven Health Services
Andrew Joseph Esposito, Sr. Reimbursement Analyst
(203) 688-1993
Addresses
Street Address
330 Orchard Street
New Haven, CT 06511
Billing Address
Yale New Haven Hospital
20 York Street
New Haven, CT 06510
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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