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DSH220035X NORTH SHORE MEDICAL CENTER (Active)
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Main Details
Name
NORTH SHORE MEDICAL CENTER
Subdivision Name
NORTH SHORE MEDICAL CENTER I - SLM OP MH CLINIC LMV
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220035X
Medicare Provider Number
220035
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/31/2022
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
North Shore Medical Center
Charles E Adams, Executive Director, Finance
(978) 354-4000
Primary Contact
Mass General Brigham - Boston, MA
Rafic Nehme, Enterprise Director
(617) 726-5125
Addresses
Street Address
480 LYNNFIELD ST
LYNN, MA 01904-1419
Billing Address
North Shore Medical Center, Inc,
81 Highland Ave
Salem, MA 01970
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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