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DSH330028J RICHMOND UNIVERSITY MEDICAL CENTER (Active)
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Main Details
Name
RICHMOND UNIVERSITY MEDICAL CENTER
Subdivision Name
Outpatient Cancer Center - Outpatient Cancer Treatment Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330028J
Medicare Provider Number
330028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/26/2020
Participating Start Date
3/27/2020
Participating Approval Date
3/27/2020
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Richmond Medical Center
David Stephen Murray, Chief Financial Officer
(718) 818-3295
Primary Contact
Richmond Medical Center
Nicholas Galeno, 340B Compliance Manager
(718) 818-2077
Addresses
Street Address
355 Bard Avenue
Staten Island, NY 10310
Billing Address
Richmond University Medical Center
355 BARD AVENUE
STATEN ISLAND, NY 10310
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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