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DSH070010CG BRIDGEPORT HOSPITAL (Active)
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Main Details
Name
BRIDGEPORT HOSPITAL
Subdivision Name
MH ALLERGY IMM MILFORD - Allergy and Immunology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH070010CG
Medicare Provider Number
070010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/28/2023
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Yale New Haven Health Services
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Primary Contact
Yale New Haven Health Services
Andrew Joseph Esposito, Sr. Reimbursement Analyst
(203) 688-1993
Addresses
Street Address
300 Seaside Ave
Diagnostic Treatment Center
MILFORD, CT 06460
Billing Address
Bridgeport Hospital
267 Grant Street
Bridgeport, CT 06610
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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