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DSH330234AP WESTCHESTER MEDICAL CENTER (Terminated)
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Main Details
Name
WESTCHESTER MEDICAL CENTER
Subdivision Name
WMC HEART AND VASCULAR IMAGING CENTER - RADIOLOGY - IMAGING
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330234AP
Medicare Provider Number
330234
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/1/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/1/2019
Last Recertification Date
9/11/2019
Termination Date
Termination Reason
10/1/2020
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Westchester Medical Center
Anthony Costello, COO
(914) 493-7028
Primary Contact
Westchester Medical Center
Varghese Thankachen, Network Director of Pharmacy Business Operations
(914) 493-7205
Addresses
Street Address
19 BRADHURST AVE
Hawthorne, NY 10532
Billing Address
Westchester Medical Center
100 Woods Road
VALHALLA, NY 10595
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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