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DSH330286 GOOD SAMARITAN HOSPITAL (Terminated)
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Main Details
Name
GOOD SAMARITAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330286
Medicare Provider Number
330286
Additional Details
Current Program Status
Terminated
Registration Date
10/11/2022
Participating Start Date
11/7/2022
Participating Approval Date
11/7/2022
Last Recertification Date
Termination Date
Termination Reason
7/1/2023
DSH percentage below statutory minimum
Contacts
Authorizing Official
Good Samaritan Hospital
Stephen Trapani, SVP Finance
(631) 376-3583
Primary Contact
Good Samaritan Hospital
James Alfiero, Director of Pharmacy
(631) 376-4435
Addresses
Street Address
1000 MONTAUK HIGHWAY
WEST ISLIP, NY 11795
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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