340B Drug Pricing Program Database
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DSH070010P BRIDGEPORT HOSPITAL (Terminated)
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Main Details
Name
BRIDGEPORT HOSPITAL
Subdivision Name
0027BH PCC BEHAVIORAL HEALTH POSTPARTUM CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070010P
Medicare Provider Number
070010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/8/2018
Last Recertification Date
9/16/2022
Termination Date
Termination Reason
7/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Yale New Haven Health Services
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Primary Contact
Yale New Haven Health Services
Andrew Joseph Esposito, Sr. Reimbursement Analyst
(203) 688-1993
Addresses
Street Address
226 MILL HILL AVENUE
1st Flr
BRIDGEPORT, CT 06610-2826
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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