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DSH070022FT YALE NEW HAVEN HOSPITAL (Terminated)
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Main Details
Name
YALE NEW HAVEN HOSPITAL
Subdivision Name
YNH BRANFORD AMBULATORY CARDIOLOGY - YNH BRANFORD AMBULATORY CARDIOLOGY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070022FT
Medicare Provider Number
070022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/24/2019
Last Recertification Date
9/15/2022
Termination Date
Termination Reason
1/1/2023
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
84 NORTH MAIN STREET
BRANFORD, CT 06405
Billing Address
YALE NEW HAVEN HOSPITAL
20 YORK STREET
NEW HAVEN, CT 06510
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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