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DSH220074CN SOUTHCOAST HOSPITALS GROUP, INC (Active)
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Main Details
Name
SOUTHCOAST HOSPITALS GROUP, INC
Subdivision Name
TOBEY HOSPITAL - RADIOLOGY - DIAGNOSTIC - TOH ULTRASOUND
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220074CN
Medicare Provider Number
220074
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/7/2017
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Southcoast Health
Renee Clark, Exec. Vice President & Chief Operating Officer
(508) 973-5872
Primary Contact
Southcoast Health
Donald Dean, Pharmacy Director
(508) 973-3022
Addresses
Street Address
43 HIGH ST
WAREHAM, MA 02571-2097
Billing Address
Southcoast Hospitals Group, Inc.
200 Mill Road, Suite 230
Fairhaven, MA 02719
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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