340B Drug Pricing Program Database
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DSH070010BS BRIDGEPORT HOSPITAL (Terminated)
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Main Details
Name
BRIDGEPORT HOSPITAL
Subdivision Name
BH REACH ADULT - Psychiatry
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070010BS
Medicare Provider Number
070010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/23/2021
Last Recertification Date
9/10/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Yale New Haven Health System
Mary G Messina, Director, Regulatory Reimbursement YNHHS
(203) 688-8543
Primary Contact
Yale New Haven Health Services
Andrew Joseph Esposito, Sr. Reimbursement Analyst
(203) 688-1993
Addresses
Street Address
305 BOSTON AVENUE, FIRST FLOOR
STRATFORD, CT 06614
Billing Address
Bridgeport Hospital
267 Grant Street
Bridgeport, CT 06610
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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