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DSH070022GS YALE NEW HAVEN HOSPITAL (Terminated)
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Main Details
Name
YALE NEW HAVEN HOSPITAL
Subdivision Name
SRC PEDIATRIC PRIMARY CARE FOSTER CARE CLINIC - PRIMARY CARE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070022GS
Medicare Provider Number
070022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/18/2020
Last Recertification Date
9/16/2022
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Yale New Haven Health Services
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Primary Contact
Yale New Haven Health Services
Andrew Joseph Esposito, Sr. Reimbursement Analyst
(203) 688-1993
Addresses
Street Address
1450 Chapel Street
2ND FLOOR SUITE R2200, ROOM R2203
NEW HAVEN, CT 06510
Billing Address
Yale- New Haven Hospital
20 York Street
New Haven, CT 06510
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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