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DSH330350F UNIVERSITY HOSPITAL OF BROOKLYN (Terminated)
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Main Details
Name
UNIVERSITY HOSPITAL OF BROOKLYN
Subdivision Name
UHB Family Health Services - Family Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330350F
Medicare Provider Number
330350
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/7/2019
Last Recertification Date
8/17/2023
Termination Date
Termination Reason
4/1/2024
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
SUNY Downstate
Sean Patrick Smith, Senior Associate Vice President & Deputy Chief Financial Officer
(718) 826-4943
Primary Contact
UNIVERSITY HOSPITAL OF BROOKLYN
Hossameldin Ghanem, Pharmacy 340B Manager
(718) 270-7648
Addresses
Street Address
840 Lefferts Ave
brooklyn, NY 11203
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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