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RRC070034-05 NORWALK HOSPITAL (Terminated)
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Main Details
Name
NORWALK HOSPITAL
Subdivision Name
Westport Radiology - Radiology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC070034-05
Medicare Provider Number
070034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/1/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/30/2024
Last Recertification Date
8/16/2024
Termination Date
Termination Reason
4/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Nuvance Health
Karen Steele, VP Pharmacy Services
(845) 472-9571
Primary Contact
Norwalk Hospital Association
Sharlene Horner, Director of Goverment Reimbursement
(860) 307-0121
Addresses
Street Address
333 Post Rd West
Westport, CT 06880
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (10/01/2020) until terminated effective date: (04/01/2023); reinstatement effective date: (07/1/2024)
04/26/2024
June 2025
June 2025
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