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DSH070006C THE STAMFORD HOSPITAL (Active)
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Main Details
Name
THE STAMFORD HOSPITAL
Subdivision Name
TULLY ENDOSCOPY CENTER - Endoscopy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070006C
Medicare Provider Number
070006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/5/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/9/2018
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Stamford Health
Ellen Komar, CNO & Sr VP -Patient Services
(203) 276-7401 Ext: 7401
Primary Contact
Stamford Hospital
Prudence Manirakiza, Pharmacy Business Manager
(203) 276-4232 Ext: 4232
Addresses
Street Address
32 Strawberry Hill Court
Stamford, CT 06902
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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