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DSH330194R MAIMONIDES MEDICAL CENTER (Active)
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Main Details
Name
MAIMONIDES MEDICAL CENTER
Subdivision Name
Maimonides Doctors Multispecialty Pavilion - Cardiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330194R
Medicare Provider Number
330194
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/4/2021
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Maimonides Medical Center
John Marshall, EVP MedAffair/Chair MedOfficer
(718) 283-8313
Primary Contact
Maimonides Medical Center
Yevgenia Bukher, Assistant Director, Pharmacy
(718) 283-7232
Addresses
Street Address
4813 9TH Avenue
Seventh Floor
Brooklyn, NY 11220
Billing Address
Maimonides Medical Center
4802 10TH Avenue
Brooklyn, NY 11219
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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