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DSH310019BG St. Joseph’s University Medical Center (Terminated)
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Main Details
Name
St. Joseph’s University Medical Center
Subdivision Name
ST JOSEPH'S REGIONAL MEDICAL CENTER / DePaul - Adolescent
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310019BG
Medicare Provider Number
310019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/5/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/1/2017
Last Recertification Date
8/16/2018
Termination Date
Termination Reason
10/1/2019
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
St. Joseph's Hospital & Medical Center
Kevin Slavin, President and CEO
(973) 754-2002 Ext: 9737542010
Primary Contact
St. Joseph's Health
Dennis Roemer, CFO
(973) 754-2023
Addresses
Street Address
11 GETTY AVE, BLDG 275
PATERSON, NJ 07503-2806
Billing Address
St. Joseph's Hospital and Medical Center
703 Main Street
Paterson, NJ 07503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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