340B Drug Pricing Program Database
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DSH070010AT BRIDGEPORT HOSPITAL (Terminated)
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Main Details
Name
BRIDGEPORT HOSPITAL
Subdivision Name
BH SURGEASE OR - MINOR SURGERY OPERATING ROOM
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070010AT
Medicare Provider Number
070010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/24/2019
Last Recertification Date
Termination Date
Termination Reason
1/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Bridgeport Hospital
PATRICK MCCABE, SENIOR VP FINANCE/CFO
(203) 688-2345
Primary Contact
Yale New Haven Health System
Mary G Messina, Director, Regulatory Reimbursement YNHHS
(203) 688-8543
Addresses
Street Address
267 GRANT STREET
BRIDGEPORT, CT 06610-2805
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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