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DSH310092G CAPITAL HEALTH SYSTEM - FULD (Active)
Main Details
Name
CAPITAL HEALTH SYSTEM - FULD
Subdivision Name
Satellite Emergency Department - East Trenton - Emergency
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH310092G
Medicare Provider Number
310092
Outpatient Facility Provider Number
Contacts
Authorizing Official
Capital Health System., Inc.
Laura McGuire, CCO
(609) 394-6783
Primary Contact
Capital Health System, Inc.
Kenneth John Bevenour, Director of Pharmacy
(609) 815-7657
Additional Details
Current Program Status
Active
Registration Date
1/20/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/7/2023
Last Recertification Date
9/8/2023
Addresses
Street Address
601 Hamilton Avenue
Trenton, NJ 08629
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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