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DSH070024 THE WILLIAM W. BACKUS HOSPITAL (Active)
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Main Details
Name
THE WILLIAM W. BACKUS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070024
Medicare Provider Number
070024
Additional Details
Current Program Status
Active
Registration Date
3/9/2023
Participating Start Date
3/13/2023
Participating Approval Date
3/13/2023
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Hartford HealthCare
Anthony Mastroianni, Regional Vice President, Finance
(860) 889-8331 Ext: 2311
Primary Contact
Hartford HealthCare
Elyse Anna Lanteigne, 340B Program Manager
(860) 972-5030
Addresses
Street Address
326 WASHINGTON STREET
NORWICH, CT 06360
Billing Address
The William W. Backus Hospital
PO Box 5037
Attn:Accounts Payable
Hartford, CT 06102
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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