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DSH220033AY BEVERLY HOSPITAL (Active)
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Main Details
Name
BEVERLY HOSPITAL
Subdivision Name
ADDISON GILBERT HOSPITAL / AGH EMERGENCY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220033AY
Medicare Provider Number
220033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/24/2017
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Beverly Hospital
Gregory Beaumier, CFO - Beverly Hospital
(978) 816-2587
Primary Contact
BILH
Jennifer Rossi, 340B Director of Compliance and Advocacy
(207) 266-9127
Addresses
Street Address
298 Washington Street
Ground Floor
Gloucester, MA 01930
Billing Address
Beverly Hospital
85 Herrick Street
Beverly, MA 01915
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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