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DSH330125U ROCHESTER GENERAL HOSPITAL (Terminated)
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Main Details
Name
ROCHESTER GENERAL HOSPITAL
Subdivision Name
RGH NEUROLOGY @ MOB - NEUROLOGY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330125U
Medicare Provider Number
330125
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/16/2019
Last Recertification Date
Termination Date
Termination Reason
7/1/2020
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Rochester Regional Health
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941
Primary Contact
Rochester Regional
Karen M Kinter, Vice President of Specialty Revenue Programs
(585) 368-3537
Addresses
Street Address
1415 Portland Avenue
Suite 445
Rochester, NY 14621
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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