Covered Entity Details

RRC330164-29 HIGHLAND HOSPITAL OF ROCHESTER (Active) - information as of 4/23/2025 10:53:26 PM

Main Details

Name

HIGHLAND HOSPITAL OF ROCHESTER

Subdivision Name

GREECE DIABETES - GREECE DIABETES

Type

Rural Referral Center

Rural

Yes

340B ID

RRC330164-29

Medicare Provider Number

330164

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/3/2025

Participating Start Date

4/1/2025

Participating Approval Date

2/18/2025

Last Recertification Date

Contacts

Authorizing Official

Strong Memorial Hospital & Highland Hospital
Carrie Fuller Spencer, Chief Financial Officer
(585) 275-3033

Primary Contact

UR Medicine
Katy Lees, Director, 340B Policy and Business Strategy
(585) 703-5169 Ext: 5855964002

Addresses

Street Address

10 South Pointe Landing
Suite 210
Rochester, NY 14606

Billing Address

Highland Hospital
1000 South Avenue
Rochester, NY 14620

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
NY	03743107,02998245	1972548568

Shipping Addresses

Shipping Address 1

Highland Hospital
1000 South Avenue
Rochester, NY 14620

Shipping Address 2

STRONG MEMORIAL HOSPITAL
CONSOLIDATED SERVICES CENTER
155 BELLWOOD DRIVE
ROCHESTER, NY 14606

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
RRC330164-01	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	AVON FAMILY MEDICINE	470 COLLINS ST	AVON	NY	Active
RRC330164-02	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	CALEDONIA MEDICAL CENTER	3350 BROWN RD	CALEDONIA	NY	Active
RRC330164-03	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	CULVER MEDICAL GROUP	913 CULVER RD	ROCHESTER	NY	Active
RRC330164-04	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	EAST RIDGE FAMILY MEDICINE	999 E RIDGE RD	ROCHESTER	NY	Active
RRC330164-05	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	WEBSTER FAMILY MEDICINE	1900 EMPIRE BLVD	WEBSTER	NY	Active
RRC330164-06	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	GENESEE VALLEY FAMILY MEDICINE	118 MAIN ST	MOUNT MORRIS	NY	Terminated
RRC330164-07	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	GENESEE VALLEY FAMILY MEDICINE	3509 THOMAS DRIVE	LAKEVILLE	NY	Active
RRC330164-08	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	GENESEE VALLEY FAMILY MEDICINE	48 E South Street	GENESEO	NY	Active
RRC330164-09	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND BREAST CARE CENTER	500 RED CREEK DR	ROCHESTER	NY	Active
RRC330164-10	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND ENDOCRINOLOGY	2400S CLINTON AVE H	ROCHESTER	NY	Active
RRC330164-11	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND FAMILY MEDICINE	777 S CLINTON AVE	ROCHESTER	NY	Active
RRC330164-13	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	PENFIELD FAMILY MEDICINE	2212 PENFIELD RD	PENFIELD	NY	Active
RRC330164-17	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	SANDS CANCER CENTER	395 West Street	CANANDAIGUA	NY	Active
RRC330164-18	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND WOMENS HEALTH	990 SOUTH AVENUE	ROCHESTER	NY	Active
RRC330164-19	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	GREECE MEDICAL GROUP	10 South Pointe Landing	ROCHESTER	NY	Active
RRC330164-20	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND WOMEN'S HEALTH AT CULVER	909 CULVER RD	ROCHESTER	NY	Active
RRC330164-21	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	DAISY MARQUIS JONES RADIATION ONCOL	155 Bellwood Drive	Rochester	NY	Active
RRC330164-22	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	CALKINS CREEK FAMILY MEDICINE	200 RED CREEK DR	ROCHESTER	NY	Active
RRC330164-23	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	Cardiology	600 Red Creek Drive	Rochester	NY	Terminated
RRC330164-24	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND CARDIOLOGY AT RED CREEK - REDCK CARDIOLOGY	600 RED CREEK DRIVE	ROCHESTER	NY	Active
RRC330164-25	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND HOSPITAL OF ROCHESTER - Geriatrics and Medicine Associates	990 SOUTH AVENUE	ROCHESTER	NY	Active
RRC330164-26	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND HOSPITAL OF ROCHESTER - HH POB PULMONARY	990 SOUTH AVENUE	ROCHESTER	NY	Active
RRC330164-27	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND WOMEN'S HEALTH - PERINTON HWH OBGYN	800 AYRAULT RD	FAIRPORT	NY	Active
RRC330164-28	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND WOMEN'S HEALTH - YMCA-SE HWH OBGYN	2300 W JEFFERSON RD	PITTSFORD	NY	Terminated
RRC330164-29	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	GREECE DIABETES - GREECE DIABETES	10 South Pointe Landing	Rochester	NY	Active
RRC330164-30	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	CULVER MEDICAL GROUP - CULVER MED GRP BH	913 CULVER RD	ROCHESTER	NY	Active
RRC330164-31	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND HOSPITAL PROFESSIONAL OFFI - HH POB LIFESTYLE MED/PALLIATIVE CARE	990 SOUTH AVE	ROCHESTER	NY	Active
RRC330164-32	Child	RRC	HIGHLAND HOSPITAL OF ROCHESTER	HIGHLAND HOSPITAL PROFESSIONAL OFFI - HH POB DIABETES HEALTH	990 SOUTH AVE	ROCHESTER	NY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Fuller Spencer, Carrie Chief Financial Officer Strong Memorial Hospital & Highland Hospital 5852753033	2/18/2025 11:05 AM
Details	340B ID	Update	New Registration		RRC330164-29	2/18/2025 11:05 AM
Details	Entity Name	Update	New Registration	HIGHLAND HOSPITAL	HIGHLAND HOSPITAL OF ROCHESTER	2/18/2025 11:05 AM
Details	Entity Subname	Update	New Registration	GREECE DIABETES	GREECE DIABETES - GREECE DIABETES	2/18/2025 11:05 AM
Dates	Participating Approval Date	Update	New Registration		2/18/2025 11:05:57 AM	2/18/2025 11:05 AM
Details	State	Update	New Registration	Pending	Approved	2/18/2025 11:05 AM
Dates	Signed By Date	Update	New Registration		1/7/2025 4:29:05 PM	2/18/2025 11:05 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	2/18/2025 11:05 AM
Addresses	Main Address	Insert	New Registration		10 South Pointe Landing Suite 210 Rochester, NY 14606	1/3/2025 7:28 PM
Addresses	Billing Address	Insert	New Registration		Highland Hospital 1000 South Avenue Rochester, NY 14620	1/3/2025 7:28 PM
Addresses	Shipping Address	Insert	New Registration		Highland Hospital 1000 South Avenue Rochester, NY 14620	1/3/2025 7:28 PM
Addresses	Shipping Address	Insert	New Registration		STRONG MEMORIAL HOSPITAL CONSOLIDATED SERVICES CENTER 155 BELLWOOD DRIVE ROCHESTER, NY 14606	1/3/2025 7:28 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/3/2025 7:28 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03743107	1/3/2025 7:28 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	1/3/2025 7:28 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/3/2025 7:28 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02998245	1/3/2025 7:28 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	1/3/2025 7:28 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1972548568	1/3/2025 7:28 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	1/3/2025 7:28 PM
Contacts	Primary Contact	Insert	New Registration		Lees, Katy Director, 340B Policy and Business Strategy UR Medicine 5857035169-5855964002	1/3/2025 7:28 PM
Contacts	Authorizing Official	Insert	New Registration		Fuller Spencer, Carrie Chief Financial Officer Strong Memorial Hospital & Highland Hospital 5852753033	1/3/2025 7:28 PM
Details	Assistance Received From Date	Insert	New Registration			1/3/2025 7:28 PM
Details	Assistance Received To Date	Insert	New Registration			1/3/2025 7:28 PM
Details	Last Recertification Date	Insert	New Registration			1/3/2025 7:28 PM
Details	Grant Number	Insert	New Registration			1/3/2025 7:28 PM
Details	340B ID	Insert	New Registration			1/3/2025 7:28 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/3/2025 7:28 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/3/2025 7:28 PM
Details	Medicare Provider Number	Insert	New Registration		330164	1/3/2025 7:28 PM
Details	Entity Name	Insert	New Registration		HIGHLAND HOSPITAL	1/3/2025 7:28 PM
Details	NOFO Number	Insert	New Registration			1/3/2025 7:28 PM
Details	Program Code	Insert	New Registration		RRC	1/3/2025 7:28 PM
Details	Entity Subname	Insert	New Registration		GREECE DIABETES	1/3/2025 7:28 PM
Dates	Participating Approval Date	Insert	New Registration			1/3/2025 7:28 PM
Details	State	Insert	New Registration		Pending	1/3/2025 7:28 PM
Dates	Registration Date	Insert	New Registration		1/3/2025 7:28:54 PM	1/3/2025 7:28 PM
Dates	Signed By Date	Insert	New Registration			1/3/2025 7:28 PM
Dates	Start Date	Insert	New Registration			1/3/2025 7:28 PM
Terminations	Termination Comments	Insert	New Registration			1/3/2025 7:28 PM
Terminations	Termination Date	Insert	New Registration			1/3/2025 7:28 PM
Terminations	Termination Effective Date	Insert	New Registration			1/3/2025 7:28 PM
Terminations	Termination Reason	Insert	New Registration			1/3/2025 7:28 PM