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DSH300014 FRISBIE MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
FRISBIE MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH300014
Medicare Provider Number
300014
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2018
Participating Start Date
7/1/2018
Participating Approval Date
5/18/2018
Last Recertification Date
8/20/2018
Termination Date
Termination Reason
4/1/2019
DSH percentage below statutory minimum
Contacts
Authorizing Official
Frisbie Memorial Hospital
Jocelyn Field Caple, President,CEO
(603) 332-5211 Ext: 8103
Primary Contact
Frisbie Memorial Hospital
Marcia Montminy Lane, Director of Pharmacy
(603) 335-8162
Addresses
Street Address
11 WHITEHALL ROAD
ROCHESTER, NH 03867
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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