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DSH330233CB BROOKDALE HOSPITAL MEDICAL CENTER (Active)
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Main Details
Name
BROOKDALE HOSPITAL MEDICAL CENTER
Subdivision Name
BHMC-Bishop Walker Ophthalmology - Ophthalmology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330233CB
Medicare Provider Number
330233
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/25/2021
Participating Start Date
6/1/2021
Participating Approval Date
5/28/2021
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Brookdale Hospital Medical Center
Diana Sullivan, VP
(718) 240-7449
Primary Contact
Brookdale Hospital
Johnny Ha, Director of Pharmacy
(718) 240-5994
Addresses
Street Address
528 Prospect Place
BROOKLYN, NY 11213
Billing Address
BROOKDALE HOSPITAL MEDICAL CENTER
ONE BROOKDLAE PLAZA
BROOKLYN, NY 11212
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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