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DSH070022EQ YALE NEW HAVEN HOSPITAL (Terminated)
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Main Details
Name
YALE NEW HAVEN HOSPITAL
Subdivision Name
PRIMARY CARE CLINIC ADULT - PCC ADULT PSYCHIATRY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070022EQ
Medicare Provider Number
070022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/23/2018
Last Recertification Date
9/11/2020
Termination Date
Termination Reason
1/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Yale New Haven Hospital
Michael Loftus, Vice President - Finance
(203) 200-3833
Primary Contact
Yale New Haven Health System
Mary G Messina, Director, Regulatory Reimbursement YNHHS
(203) 688-8543
Addresses
Street Address
789 HOWARD AVENUE
New Haven, CT 06519
Billing Address
YALE NEW HAVEN HOSPITAL
20 YORK STREET
NEW HAVEN, CT 06510-3220
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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