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DSH070029A BRISTOL HOSPITAL INC (Active)
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Main Details
Name
BRISTOL HOSPITAL INC
Subdivision Name
BRISTOL HOSPITAL COUNSELING CENTER - Behavioral Health Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH070029A
Medicare Provider Number
070029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/25/2023
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Bristol Hospital
Kurt Barwis, President
(860) 585-3222
Primary Contact
Bristol Hospital
Timothy Ajayi, CFO
(860) 585-3024
Addresses
Street Address
420 N MAIN ST
BRISTOL, CT 06010-4923
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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