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DSH330233K BROOKDALE HOSPITAL MEDICAL CENTER (Active)
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Main Details
Name
BROOKDALE HOSPITAL MEDICAL CENTER
Subdivision Name
BFCC at Bristol GI - GI
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330233K
Medicare Provider Number
330233
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2017
Participating Start Date
1/1/2018
Participating Approval Date
11/1/2017
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Brookdale Hospital Medical Center
Diana Sullivan, VP
(718) 240-7449
Primary Contact
Brookdale Hospital
Johnny Ha, Director of Pharmacy
(718) 240-5994
Addresses
Street Address
1235 Linden Blvd
Brooklyn, NY 11212
Billing Address
Brookdale Hospital Medical Center
One Brookdale Plaza
Brooklyn, NY 11212
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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