Covered Entity Details

RRC330164-32 HIGHLAND HOSPITAL OF ROCHESTER (Active) - information as of 4/27/2025 12:53:10 AM

Main Details

Name

HIGHLAND HOSPITAL OF ROCHESTER

Subdivision Name

HIGHLAND HOSPITAL PROFESSIONAL OFFI - HH POB DIABETES HEALTH

Type

Rural Referral Center

Rural

Yes

340B ID

RRC330164-32

Medicare Provider Number

330164

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

3/24/2025

Participating Start Date

4/1/2025

Participating Approval Date

3/27/2025

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

990 SOUTH AVE
ROCHESTER, NY 14620-2763

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

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	3/27/2025 7:22 AM
Details	340B ID	Update	New Registration		RRC330164-32	3/27/2025 7:22 AM
Details	Entity Name	Update	New Registration	HIGHLAND HOSPITAL	HIGHLAND HOSPITAL OF ROCHESTER	3/27/2025 7:22 AM
Details	Entity Subname	Update	New Registration	HIGHLAND HOSPITAL PROFESSIONAL OFFI	HIGHLAND HOSPITAL PROFESSIONAL OFFI - HH POB DIABETES HEALTH	3/27/2025 7:22 AM
Dates	Participating Approval Date	Update	New Registration		3/27/2025 7:22:00 AM	3/27/2025 7:22 AM
Details	State	Update	New Registration	Pending	Approved	3/27/2025 7:22 AM
Dates	Signed By Date	Update	New Registration		3/26/2025 2:15:51 PM	3/27/2025 7:22 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	3/27/2025 7:22 AM
Addresses	Main Address	Insert	New Registration		990 SOUTH AVE ROCHESTER, NY 14620-2763	3/24/2025 2:42 PM
Addresses	Billing Address	Insert	New Registration		Highland Hospital 1000 South Avenue Rochester, NY 14620	3/24/2025 2:42 PM
Addresses	Shipping Address	Insert	New Registration		Highland Hospital 1000 South Avenue Rochester, NY 14620	3/24/2025 2:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	3/24/2025 2:42 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03743107	3/24/2025 2:42 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	3/24/2025 2:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	3/24/2025 2:42 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		02998245	3/24/2025 2:42 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	3/24/2025 2:42 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1972548568	3/24/2025 2:42 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	3/24/2025 2:42 PM
Contacts	Primary Contact	Insert	New Registration		Lees, Katy Director, 340B Policy and Business Strategy UR Medicine 5857035169-5855964002	3/24/2025 2:42 PM
Contacts	Authorizing Official	Insert	New Registration		Fuller Spencer, Carrie Chief Financial Officer Strong Memorial Hospital & Highland Hospital 5852753033	3/24/2025 2:42 PM
Details	Assistance Received From Date	Insert	New Registration			3/24/2025 2:42 PM
Details	Assistance Received To Date	Insert	New Registration			3/24/2025 2:42 PM
Details	Last Recertification Date	Insert	New Registration			3/24/2025 2:42 PM
Details	Grant Number	Insert	New Registration			3/24/2025 2:42 PM
Details	340B ID	Insert	New Registration			3/24/2025 2:42 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			3/24/2025 2:42 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			3/24/2025 2:42 PM
Details	Medicare Provider Number	Insert	New Registration		330164	3/24/2025 2:42 PM
Details	Entity Name	Insert	New Registration		HIGHLAND HOSPITAL	3/24/2025 2:42 PM
Details	NOFO Number	Insert	New Registration			3/24/2025 2:42 PM
Details	Program Code	Insert	New Registration		RRC	3/24/2025 2:42 PM
Details	Entity Subname	Insert	New Registration		HIGHLAND HOSPITAL PROFESSIONAL OFFI	3/24/2025 2:42 PM
Dates	Participating Approval Date	Insert	New Registration			3/24/2025 2:42 PM
Details	State	Insert	New Registration		Pending	3/24/2025 2:42 PM
Dates	Registration Date	Insert	New Registration		3/24/2025 2:42:33 PM	3/24/2025 2:42 PM
Dates	Signed By Date	Insert	New Registration			3/24/2025 2:42 PM
Dates	Start Date	Insert	New Registration			3/24/2025 2:42 PM
Terminations	Termination Comments	Insert	New Registration			3/24/2025 2:42 PM
Terminations	Termination Date	Insert	New Registration			3/24/2025 2:42 PM
Terminations	Termination Effective Date	Insert	New Registration			3/24/2025 2:42 PM
Terminations	Termination Reason	Insert	New Registration			3/24/2025 2:42 PM