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DSH080001Q CHRISTIANA CARE HEALTH SYSTEM (Terminated)
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Main Details
Name
CHRISTIANA CARE HEALTH SYSTEM
Subdivision Name
ChristianaCare Dermatology - Dermatology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH080001Q
Medicare Provider Number
080001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2020
Participating Start Date
10/1/2020
Participating Approval Date
8/4/2020
Last Recertification Date
9/1/2023
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
Christiana Care Health System
Robert McMurray, Chief Financial Officer
(302) 623-7202
Primary Contact
Christiana Care Health System
Samuel Wetherill, Vice President, Pharmacy Services
(302) 733-3550
Addresses
Street Address
4735 Ogletown-Stanton Road
MAP 2
Suite 3203
Newark, DE 19713
Billing Address
Christiana Care Health System
P.O. Box 2653
Attn: Accounts Payable
Wilmington, DE 19805
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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