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DSH330128Y ELMHURST HOSPITAL CENTER (NYCHHC) (Terminated)
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Main Details
Name
ELMHURST HOSPITAL CENTER (NYCHHC)
Subdivision Name
Meyers Clinic - Mental Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330128Y
Medicare Provider Number
330128
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/7/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/27/2020
Last Recertification Date
8/16/2021
Termination Date
Termination Reason
10/1/2022
Site closure
Contacts
Authorizing Official
NYC Health + Hospitals
Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446
Primary Contact
New York City Health and Hospitals
Min Than, Assistant Vice President
(212) 442-3854
Addresses
Street Address
600 E.125 St.
7th Fl
Wards Island, NY 10035
Billing Address
Elmhurst Hospital center
79-01 BROADWAY
Elmhurst, NY 11373
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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