340B Drug Pricing Program Database


DSH330276C NATHAN LITTAUER HOSPITAL (Active) - information as of 5/27/2025 11:36:46 PM

Main Details
NATHAN LITTAUER HOSPITAL
Mayfield Primary Care Center - Internal Medicine
Disproportionate Share Hospital
Yes
DSH330276C
330276
330276


Additional Details
Active
7/11/2014
10/1/2014
9/12/2014
8/19/2024

Contacts

Nathan Littauer Hospital
Michael Ostrander, Vice President-Finance & CFO
(518) 773-5480

Nathan Littauer Hospital
Brenda Hammons, Pharmacy 340B Coordinator
(518) 773-5582

Addresses

2497 State Highway 30
Mayfield, NY 12117

Nathan Littauer Hospital
99 East State Street
Gloversville, NY 12078


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Nathan Littauer Hospital
99 East State Street
Gloversville, NY 12078
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH330276AChildDSHNATHAN LITTAUER HOSPITALJohnstown Primary/Specialty Care Center110 Decker Drive Suite 100JohnstownNYActive
DSH330276AAChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Urology99 East State StreetGloversvilleNYActive
DSH330276ABChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Neurology99 East State StreetGloversvilleNYActive
DSH330276ACChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Surgery99 East State StreetGloversvilleNYActive
DSH330276ADChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Women's Health99 East State StreetGloversvilleNYActive
DSH330276AEChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Anesthesia99 East State StreetGloversvilleNYTerminated
DSH330276AFChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Internal Medicine99 East State StreetGloversvilleNYActive
DSH330276AGChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Family Practice99 East State StreetGloversvilleNYActive
DSH330276AHChildDSHNATHAN LITTAUER HOSPITALBroadalbin Primary/Specialty Care103 COUNTY HIGHWAY 138BROADALBINNYActive
DSH330276AJChildDSHNATHAN LITTAUER HOSPITALSteele Avenue Primary Care Center - Otolaryngology182 Steele AvenueGloversvilleNYActive
DSH330276AKChildDSHNATHAN LITTAUER HOSPITALAmsterdam Primary/Urgent Care Center - Primary Care375 Golf Course RoadAmsterdamNYActive
DSH330276ALChildDSHNATHAN LITTAUER HOSPITALAmsterdam Primary/Urgent Care Center - Urgent Care375 Golf Course RoadAmsterdamNYActive
DSH330276BChildDSHNATHAN LITTAUER HOSPITALMayfield Primary Care Center - Family Practice2497 State Highway 30MayfieldNYActive
DSH330276CChildDSHNATHAN LITTAUER HOSPITALMayfield Primary Care Center - Internal Medicine2497 State Highway 30MayfieldNYActive
DSH330276DChildDSHNATHAN LITTAUER HOSPITALMayfield Primary Care Center - Pediatrics2497 State Highway 30MayfieldNYTerminated
DSH330276EChildDSHNATHAN LITTAUER HOSPITALPrimary Care Center at Speculator - Internal Medicine2862 State Highway 8SpeculatorNYActive
DSH330276FChildDSHNATHAN LITTAUER HOSPITALCaroga Lake Primary Care Center - Family Practice1840 State Highway 10Caroga LakeNYActive
DSH330276GChildDSHNATHAN LITTAUER HOSPITALSteele Avenue Primary Care Center - Pediatrics182 Steele AvenueGloversvilleNYTerminated
DSH330276HChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Internal Medicine4104 State Highway 30PerthNYActive
DSH330276JChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Family Practice4104 State Highway 30PerthNYActive
DSH330276KChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Pediatrics4104 State Highway 30PerthNYActive
DSH330276LChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Women's Health4104 State Highway 30PerthNYActive
DSH330276MChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Neurology4104 State Highway 30PerthNYTerminated
DSH330276NChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Podiatry4104 State Highway 30PerthNYActive
DSH330276PChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Radiology4104 State Highway 30PerthNYTerminated
DSH330276QChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center - Occupational Medicine4104 State Highway 30PerthNYActive
DSH330276RChildDSHNATHAN LITTAUER HOSPITALPrimary/Specialty Care Center at Decker Drive - Pediatrics110 Decker DriveJohnstownNYTerminated
DSH330276SChildDSHNATHAN LITTAUER HOSPITALFonClair Terrace Primary Care Center - Primary Care2 FonClair TerraceJohnstownNYTerminated
DSH330276TChildDSHNATHAN LITTAUER HOSPITALJohnstown Surgery Center - Ambulatory Surgery434 South Kingsboro Avenue ExtensionJohnstownNYActive
DSH330276UChildDSHNATHAN LITTAUER HOSPITALPerth-Broadalbin Primary Care Center / Gastroenterology4104 State Highway 30PerthNYTerminated
DSH330276VChildDSHNATHAN LITTAUER HOSPITALKingsboro GI Center/Gastroenterology434 South Kingsboro Avenue ExtensionJohnstownNYActive
DSH330276WChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center / Gastroenterology99 East State StreetGloversvilleNYTerminated
DSH330276XChildDSHNATHAN LITTAUER HOSPITALFonda Primary/Specialty Care Center - Family Practice46 East Main StreetFondaNYActive
DSH330276YChildDSHNATHAN LITTAUER HOSPITALFonda Primary/Specialty Care Center - Internal Medicine46 East Main StreetFondaNYActive
DSH330276ZChildDSHNATHAN LITTAUER HOSPITALGloversville Primary Care Center - Pulmonology99 East State StreetGloversvilleNYActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification8/17/2023 12:03:18 PM8/19/2024 9:57:50 AM8/19/2024 9:57 AM
DetailsLast Recertification DateUpdateRecertification8/29/2022 8:28:52 AM8/17/2023 12:03:18 PM8/17/2023 12:03 PM
DetailsLast Recertification DateUpdateRecertification8/24/2021 8:26:50 AM8/29/2022 8:28:52 AM8/29/2022 8:28 AM
DetailsLast Recertification DateUpdateRecertification9/3/2020 10:51:14 AM8/24/2021 8:26:50 AM8/24/2021 8:26 AM
AddressesMain AddressUpdateChange Request Route 30 Mayfield, NY 12117 2497 State Highway 30 Mayfield, NY 1211712/8/2020 11:06 AM
DetailsLast Recertification DateUpdateRecertification9/6/2019 9:29:13 AM9/3/2020 10:51:14 AM9/3/2020 10:51 AM
DetailsLast Recertification DateUpdateRecertification8/31/2018 11:41:39 AM9/6/2019 9:29:13 AM9/6/2019 9:29 AM
ContactsPrimary ContactUpdateProfile Change RequestHammons, Brenda Assistant to the CFO & CIO Nathan Littauer Hospital 5187735485Hammons, Brenda Pharmacy 340B Coordinator Nathan Littauer Hospital 51877355821/9/2019 10:24 AM
DetailsLast Recertification DateUpdateRecertification11/22/2017 2:13:08 PM8/31/2018 11:41:39 AM8/31/2018 11:41 AM
AddressesBilling AddressInsertChange Request Nathan Littauer Hospital 99 East State Street Gloversville, NY 120787/17/2018 7:05 AM
AddressesShipping AddressInsertChange Request Nathan Littauer Hospital 99 East State Street Gloversville, NY 120787/17/2018 7:05 AM
DetailsLast Recertification DateUpdateRecertification8/26/2016 12:00:00 AM11/22/2017 2:13:08 PM11/22/2017 2:13 PM
ContactsAuthorizing OfficialUpdate Ostrander, Michael Vice President-Finance & CFO 5187735480Ostrander, Michael Vice President-Finance & CFO Nathan Littauer Hospital 518773548010/20/2017 2:08 PM
ContactsSigned ByUpdate Ostrander, Michael Vice President-Finance & CFO 5187735480Ostrander, Michael Vice President-Finance & CFO Nathan Littauer Hospital 518773548010/20/2017 2:08 PM
ContactsPrimary ContactUpdate Hammons, Brenda Assistant to the CFO & CIO 5187735485Hammons, Brenda Assistant to the CFO & CIO Nathan Littauer Hospital 518773548510/10/2017 2:28 PM
ContactsAuthorizing OfficialInsert  Ostrander, Michael Vice President-Finance & CFO 51877354805/11/2017 7:17 AM
ContactsSigned ByInsert  Ostrander, Michael Vice President-Finance & CFO 51877354805/11/2017 7:17 AM
ContactsPrimary ContactInsert  Hammons, Brenda Assistant to the CFO & CIO 51877354855/11/2017 7:17 AM
AddressesMain AddressInsert   Route 30 Mayfield, NY 121178/26/2016 2:27 PM
DetailsLast Recertification DateUpdate 9/1/2015 12:00:00 AM8/26/2016 12:00:00 AM8/26/2016 2:27 PM
DetailsLast Recertification DateUpdate  9/1/2015 12:00:00 AM9/1/2015 11:07 AM
DetailsEntity SubnameUpdate Mayfield Primary Care Center - Internal Medicine / Internal MedicineMayfield Primary Care Center - Internal Medicine12/31/2014 3:51 PM
DetailsEntity SubnameUpdate Mayfield Primary Care Center - Internal MedicineMayfield Primary Care Center - Internal Medicine / Internal Medicine12/19/2014 2:16 PM
DatesParticipating Approval DateUpdate  9/12/2014 12:00:00 AM9/12/2014 5:48 PM
DetailsStateUpdate PendingActive9/12/2014 5:48 PM
DatesStart DateUpdate  10/1/2014 12:00:00 AM9/12/2014 5:48 PM
Details340B IDUpdate OUTPATIENT_ONLINE_REG_45276DSH330276C9/11/2014 7:09 AM
DetailsEntity SubnameUpdate Mayfield Primary Care CenterMayfield Primary Care Center - Internal Medicine9/11/2014 7:09 AM
Details340B IDUpdate  OUTPATIENT_ONLINE_REG_452767/11/2014 11:35 AM
DetailsLast Recertification DateInsert   7/11/2014 11:35 AM
DetailsGrant NumberInsert   7/11/2014 11:35 AM
Details340B IDInsert   7/11/2014 11:35 AM
DetailsIs Authorizing Official EHB DataInsert   7/11/2014 11:35 AM
DatesLast Date That 340B Drugs PurchasedInsert   7/11/2014 11:35 AM
DetailsMedicare Provider NumberInsert  3302767/11/2014 11:35 AM
DetailsEntity NameInsert  NATHAN LITTAUER HOSPITAL7/11/2014 11:35 AM
DetailsProgram CodeInsert  DSH7/11/2014 11:35 AM
DetailsEntity SubnameInsert  Mayfield Primary Care Center7/11/2014 11:35 AM
DatesParticipating Approval DateInsert   7/11/2014 11:35 AM
DetailsStateInsert  Pending7/11/2014 11:35 AM
DatesRegistration DateInsert  7/11/2014 12:00:00 AM7/11/2014 11:35 AM
DatesSigned By DateInsert  7/11/2014 12:00:00 AM7/11/2014 11:35 AM
DatesStart DateInsert   7/11/2014 11:35 AM
TerminationsTermination CommentsInsert   7/11/2014 11:35 AM
TerminationsTermination DateInsert   7/11/2014 11:35 AM
TerminationsTermination Effective DateInsert   7/11/2014 11:35 AM
TerminationsTermination ReasonInsert   7/11/2014 11:35 AM