340B Drug Pricing Program Database
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DSH070007AC LAWRENCE & MEMORIAL HOSPITAL (Active)
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Main Details
Name
LAWRENCE & MEMORIAL HOSPITAL
Subdivision Name
LMH FAIRE HARBOUR REHAB SERVICES - Rehabilitation
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070007AC
Medicare Provider Number
070007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/13/2021
Last Recertification Date
9/5/2024
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
59 Faire Harbour
2nd Floor
NEW LONDON, CT 06320
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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