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DSH390115D Jefferson Health Northeast (Active)
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Main Details
Name
Jefferson Health Northeast
Subdivision Name
Bucks Campus - Operating Room
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390115D
Medicare Provider Number
390115
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Jefferson Health
CARRIE FREY, Director of Finance
(215) 612-4313
Primary Contact
Jefferson Health
Dustin Ottemiller, VP, Finance
(215) 503-5219
Addresses
Street Address
380 N. Oxford Valley Rd.
Langhorne, PA 19047-8304
Billing Address
Aria Health
PO Box 8500 6395
Philadelphia, PA 19178-8639
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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