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DSH330014L JAMAICA HOSPITAL MEDICAL CENTER (Active)
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Main Details
Name
JAMAICA HOSPITAL MEDICAL CENTER
Subdivision Name
JHMC-Extension Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330014L
Medicare Provider Number
330014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/3/2017
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Jamaica Hospital
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Primary Contact
Jamaica Hospital Medical Center
Louis Cosenza, Director
(718) 206-6052
Addresses
Street Address
130-02 115th Avenue
South Ozone Park, NY 11420
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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