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DSH310091 MEMORIAL HOSPITAL OF SALEM COUNTY (Terminated)
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Main Details
Name
MEMORIAL HOSPITAL OF SALEM COUNTY
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310091
Medicare Provider Number
310091
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/17/2020
Last Recertification Date
9/19/2022
Termination Date
Termination Reason
10/1/2023
Failure to recertify
Contacts
Authorizing Official
Salem Medical Center
vincent riccitelli, CFO
(609) 856-6077
Primary Contact
Salem Medical Center
Tammy Torres, CEO
(690) 856-3102
Addresses
Street Address
310 WOODSTOWN ROAD
SALEM, NJ 08079
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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