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DSH330231N QUEENS HOSPITAL CENTER (NYCHHC) (Terminated)
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Main Details
Name
QUEENS HOSPITAL CENTER (NYCHHC)
Subdivision Name
QHC Assertive Community Treatment I
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330231N
Medicare Provider Number
330231
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/17/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/20/2017
Last Recertification Date
9/10/2018
Termination Date
Termination Reason
10/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
New York City Health and Hospitals
Paul Albertson, Vice President
(212) 748-2256
Primary Contact
New York City Health + Hospitals
Danielle Sestito, Senior Director, 340B Operations
(212) 442-3892
Addresses
Street Address
82-68 164th Street
Jamaica, NY 11432
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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