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DSH220095P HEYWOOD HOSPITAL (Terminated)
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Main Details
Name
HEYWOOD HOSPITAL
Subdivision Name
Heywood Infectious Disease - Infectious Disease
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220095P
Medicare Provider Number
220095
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/3/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/1/2021
Last Recertification Date
8/30/2022
Termination Date
Termination Reason
4/1/2023
Other
Contacts
Authorizing Official
Heywood Hospital
Tom Sullivan, CFO
(978) 630-6157
Primary Contact
Heywood Healthcare
Lori Doucette, 340B Program Director
(978) 630-6161 Ext: 2076298672
Addresses
Street Address
250 Green Street
Suite 104
Gardner, MA 01440
Billing Address
Heywood Hospital
242 Green Street
Gardner, MA 01440
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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