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DSH070007X LAWRENCE & MEMORIAL HOSPITAL (Approved)
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Main Details
Name
LAWRENCE & MEMORIAL HOSPITAL
Subdivision Name
LMH SURGERY BREAST WATERFORD - BREAST SURGERY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070007X
Medicare Provider Number
070007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/22/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/23/2025
Last Recertification Date
Contacts
Authorizing Official
Yale New Haven Health Services
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Primary Contact
Yale New Haven Health System
Maria Da Silva, Senior Reimbursement Analyst
(203) 688-9332
Addresses
Street Address
230 WATERFORD PARKWAY SOUTH
WATERFORD, CT 06382
Billing Address
LAWRENCE+MEMORIAL HOSPITAL
365 MONTAUK AVENUE
NEW LONDON, CT 06320
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 7/1/2020, Termination 7/1/2023, Reinstatement 7/1/2025
04/23/2025
May 2025
May 2025
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