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DSH220119 Brigham and Women's Faulkner Hospital (Active)
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Main Details
Name
Brigham and Women's Faulkner Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220119
Medicare Provider Number
220119
Additional Details
Current Program Status
Active
Registration Date
4/5/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/25/2017
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Brigham and Women's Hospital - Boston, MA
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Primary Contact
Mass General Brigham - Boston, MA
Rafic Nehme, Enterprise Director
(617) 726-5125
Addresses
Street Address
1153 CENTRE STREET
Boston, MA 02130
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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