Covered Entity Details

DSH330226AN UNITY HOSPITAL OF ROCHESTER (Active) - information as of 4/25/2025 6:34:12 PM

Main Details

Name

UNITY HOSPITAL OF ROCHESTER

Subdivision Name

THE UNITY HOSPITAL SYSTEM / Unity Mental Health Greece Clinic

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH330226AN

Medicare Provider Number

330226

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/14/2016

Participating Start Date

3/15/2022

Participating Approval Date

5/10/2016

Last Recertification Date

8/28/2024

Contacts

Authorizing Official

Rochester Regional Health
Shawn Bishop, Vice President, RRH Revenue & Reimbursement
(585) 922-0056

Primary Contact

RRH
Robert Michael Scardino, 340B Pharmacy System Manager
(585) 319-6750

Addresses

Street Address

100 PINEWILD DR STE 2A
ROCHESTER, NY 14606

Billing Address

Unity Hospital
P.O.BOX 10460
Rochester, NY 14610

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	00378721	1336366822

Shipping Addresses

Shipping Address 1

Park Ridge Hospital, Inc - Genesee Campus Pharmacy
89 Genesee Street
Rochester, NY 14611

Shipping Address 2

Unity Hospital of Rochester, St. Mary's Campus
75 Genesee St
Rochester, NY 14611

Shipping Address 3

St. Mary’s Campus
ATTN: Pharmacy Department
55-75 Genesee Street
Rochester, NY 14611

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
DSH330226A	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Infectious Disease SM	55 GENESEE ST	ROCHESTER	NY	Active
DSH330226AA	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Andrew J Kirch Dialysis Center at St. Mary's	75 GENESEE ST	ROCHESTER	NY	Active
DSH330226AB	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Healthy Start	89 GENESEE ST	ROCHESTER	NY	Terminated
DSH330226AC	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Family Medicine at Parkway	500 ISLAND COTTAGE RD	ROCHESTER	NY	Active
DSH330226AD	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity OB/GYN at Clinton Crossings	995 SENATOR KEATING BLVD 210	ROCHESTER	NY	Active
DSH330226AE	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Faculty Partners	1561 LONG POND RD STE 206	ROCHESTER	NY	Active
DSH330226AF	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL SYSTEM / Unity Family Medicine at Country Village	1100 LONG POND RD STE 250	ROCHESTER	NY	Active
DSH330226AG	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Adult Day Services at St. Mary's	89 GENESEE ST 2ND FL	ROCHESTER	NY	Terminated
DSH330226AH	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity's Oncology, Hematology/Infusion Center	55 GENESEE ST BK BLDG 1ST FL	ROCHESTER	NY	Active
DSH330226AJ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity St. Mary's Campus Psychiatric Emergency	89 GENESEE ST	ROCHESTER	NY	Terminated
DSH330226AK	Child	DSH	UNITY HOSPITAL OF ROCHESTER	MENTAL HEALTH OUTPATIENT SERVICES / Evelyn Brandon Health Center Mental Health	81 LAKE AVE	ROCHESTER	NY	Active
DSH330226AL	Child	DSH	UNITY HOSPITAL OF ROCHESTER	PARK RIDGE CHEMICAL DEPENDENCY / Evelyn Brandon Health Center Chemical Dependency	81 LAKE AVE	ROCHESTER	NY	Active
DSH330226AM	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Chemical Dependency Greece Clinic	1565 LONG POND RD	ROCHESTER	NY	Active
DSH330226AN	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL SYSTEM / Unity Mental Health Greece Clinic	100 PINEWILD DR STE 2A	ROCHESTER	NY	Active
DSH330226AP	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Internal Medicine at Park Ridge	1561 LONG POND RD	ROCHESTER	NY	Active
DSH330226AQ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	DIALYSIS / Andrew J. Kirch Dialysis Center at Park Ridge	1555 LONG POND RD	ROCHESTER	NY	Terminated
DSH330226AR	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Internal Medicine at Cornerstone	2300 BUFFALO RD BLDG 800C	ROCHESTER	NY	Active
DSH330226AS	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Family Medicine at Chili Center	3379 CHILI AVE 100	ROCHESTER	NY	Active
DSH330226AT	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Infectious Disease SM 3rd FL	89 GENESEE ST BK BLDG 3RD FL	ROCHESTER	NY	Terminated
DSH330226AU	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Brockport / Unity Vascular Surgery Brockport	6668 Fourth Section Road	Brockport	NY	Terminated
DSH330226AV	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UMG PULM MED LIND OAK	10 HAGEN DRIVE	Rochester	NY	Active
DSH330226AW	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Brockport / Unity Pulmonary Medicine Brockport	6668 Fourth Section Road	Brockport	NY	ToBeTerminated
DSH330226AX	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Sleep Disorders Center	1561 Long Pond Road	Rochester	NY	Active
DSH330226AY	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Geriatrics at Brockport / Brockport	6668 Fourth Section Road	Brockport	NY	Terminated
DSH330226AZ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Brockport / Unity Diabetes & Endocrinology Brockport	6668 Fourth Section Road	Brockport	NY	Active
DSH330226B	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Park Ridge / Unity Hematology / Oncology at Park Ridge	1561 LONG POND RD.	Rochester	NY	Active
DSH330226BA	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UMG SLEEP CTR LIND OAK	10 HAGEN DRIVE	Rochester	NY	Active
DSH330226BB	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Ridgeway / Unity Wound Care Center at Ridgeway	2655 Ridgeway Ave. Suite 230	Rochester	NY	Active
DSH330226BC	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Ridgeway / Unity Vascular Surgery Ridgeway	2655 Ridgeway Avenue Suite 240	Rochester	NY	Active
DSH330226BD	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Ridgeway / Unity Neurosurgery Ridgeway	2655 Ridgeway Ave, Suite 460	Rochester	NY	Active
DSH330226BE	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Neurosurgery	2655 Ridgeway Ave., Suite 340	Rochester	NY	Active
DSH330226BF	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Long Pond / Unity Internal Medicine at Long Pond	1561 LONG POND RD	Rochester	NY	Terminated
DSH330226BG	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UNITY PULMONARY MEDICINE / Unity Pulmonary Medicine Park Ridge	1561 LONG POND RD	ROCHESTER	NY	Active
DSH330226BH	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UNITY DIABETES CENTER / Unity Diabetes & Endocrinology Ridgeway	2655 RIDGEWAY AVE	ROCHESTER	NY	Active
DSH330226BJ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UNITY AT RIDGEWAY REHABILITATION / Unity Neurosciences at Ridgeway	2655 RIDGEWAY AVE	ROCHESTER	NY	Active
DSH330226BK	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Geriatrics	105 CANAL LANDING BLVD STE 1	ROCHESTER	NY	Active
DSH330226BL	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity OB/GYN at Park Ridge	1561 LONG POND RD	ROCHESTER	NY	Active
DSH330226BM	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Dental at Penfield	2060 Fairport Nine Mile Pt Rd	Penfield	NY	Terminated
DSH330226BN	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Brockport / Unity Neurosciences	6668 Fourth Section Road	Brockport	NY	Terminated
DSH330226BP	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Assertive Community Treatment / Mental Health Clinic	81 Lake Avenue	Rochester	NY	Active
DSH330226BQ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Infectious Disease Brockport	6668 Fourth Section Road	Brockport	NY	ToBeTerminated
DSH330226BR	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Neurosurgery Elmira	301 E Church Street	Elmira	NY	Terminated
DSH330226BS	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Neurosurgery Corning	56 east First Street	Corning	NY	Terminated
DSH330226BT	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Neurosurgery Batavia	229 Summit St Suite 10	Batavia	NY	Terminated
DSH330226BU	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UNITY HEALTH SYSTEM / HEALTHREACH	89 GENESEE ST	Rochester	NY	Terminated
DSH330226BV	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Health Care for the Homeless / Health Reach Clinic	819 W Main St	Rochester	NY	Terminated
DSH330226BW	Child	DSH	UNITY HOSPITAL OF ROCHESTER	SANCTUARY HOUSE	715 DEWEY AVE	Rochester	NY	Terminated
DSH330226BX	Child	DSH	UNITY HOSPITAL OF ROCHESTER	YWCA	175 CLINTON AVE N	Rochester	NY	Terminated
DSH330226BY	Child	DSH	UNITY HOSPITAL OF ROCHESTER	WOMEN'S PLACE	140 Hobart St	Rochester	NY	Terminated
DSH330226BZ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	FRANCIS CENTER (CATHOLIC FAM CTR)	547 Joseph Ave	Rochester	NY	Terminated
DSH330226C	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Orchard Street / Unity Family Medicine at Orchard Street	158 Orchard Street	Rochester	NY	Terminated
DSH330226CA	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UNITY MOBILE MEDICAL UNIT / UNITY MOBILE MEDICAL UNIT	89 GENESEE ST	Rochester	NY	Terminated
DSH330226CB	Child	DSH	UNITY HOSPITAL OF ROCHESTER	OPEN DOOR MISSION	210 W Main St	Rochester	NY	Terminated
DSH330226CC	Child	DSH	UNITY HOSPITAL OF ROCHESTER	SALVATION ARMY BOOTH HAVEN	70 LIBERTY POLE WAY	Rochester	NY	Terminated
DSH330226CD	Child	DSH	UNITY HOSPITAL OF ROCHESTER	GENESIS HOUSE (SALVATION ARMY)	35 ARDMORE ST	Rochester	NY	Terminated
DSH330226CE	Child	DSH	UNITY HOSPITAL OF ROCHESTER	SALVATION ARMY-HOPE HOUSE	100 WEST AVE	Rochester	NY	Terminated
DSH330226CF	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UH ONCOLOGY AT PARK RIDGE - UH ONCOLOGY AT PARK RIDGE	1555 LONG POND RD	ROCHESTER	NY	Terminated
DSH330226CG	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UHS RIDGEWAY THERAPY (Ortho PT/PT/OT/SLP) - UHS RIDGEWAY THERAPY (Ortho PT/PT/OT/SLP)	2655 RIDGEWAY AVE	ROCHESTER	NY	Terminated
DSH330226CH	Child	DSH	UNITY HOSPITAL OF ROCHESTER	BH UHS HEALTH HOME - BH UHS HEALTH HOME	89 GENESEE ST	ROCHESTER	NY	Terminated
DSH330226CJ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Behavioral Health Unity Health System - Behavorial Health Access and Crisis Center - Behavioral Health Unity Health System - Behavorial Health Access and Crisis Center	89 GENESEE STREET	ROCHESTER	NY	Terminated
DSH330226CK	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UMG THYROID CENTER - UMG THYROID CENTER	1561 LONG POND RD STE 216	ROCHESTER	NY	Terminated
DSH330226CL	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UHS PIETERS Therapy (OT/PT/SLP) - UHS PIETERS Therapy (OT/PT/SLP)	1025 COMMONS WAY	ROCHESTER	NY	Terminated
DSH330226CM	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Pediatrics - Pediatrics at St. Marys	65 Genesee Street	Rochester	NY	Active
DSH330226CN	Child	DSH	UNITY HOSPITAL OF ROCHESTER	OB/GYN - St.Marys OB/GYN	65 Genesee Street	Rochester	NY	Active
DSH330226CP	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UHS ORTHO AT BROCKPORT - Orthopedics	6668 4TH SECTION RD	Brockport	NY	Active
DSH330226CQ	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Medical Group(UMG) Fertility - Fertility	1561 Long Pond Road	Rochester	NY	Active
DSH330226CR	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UHS DENTISTRY ST MARYS - Dentistry	75 Genesee Street	Rochester	NY	Active
DSH330226CS	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UHS DENTISTRY RIDGEWAY - Dentistry	2655 Ridgeway Ave	Rochester	NY	Active
DSH330226CT	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UMG FM AT STM - Family Medicine	55 Genesee Street	ROCHESTER	NY	Active
DSH330226CU	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UMG FM @ ORCHARD ST - Family Medicine	158 ORCHARD ST	ROCHESTER	NY	Active
DSH330226D	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Cornerstone / Unity Adult Day Services at Cornerstone	2300 Buffalo Road, Bldg. 600 A	Rochester	NY	Terminated
DSH330226E	Child	DSH	UNITY HOSPITAL OF ROCHESTER	St. Bernard's / Unity Adult Day Services at St. Bernard's	2260 Lake Avenue	Rochester	NY	Terminated
DSH330226F	Child	DSH	UNITY HOSPITAL OF ROCHESTER	M.S. Achievement Center at Unity	2300 Buffalo Road, Bldg. 600 B	Rochester	NY	Terminated
DSH330226G	Child	DSH	UNITY HOSPITAL OF ROCHESTER	PRH Respiratory	1561 LONG POND RD	Rochester	NY	Terminated
DSH330226H	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Spine Center	2655 Ridgeway Ave., Suite 440	Rochester	NY	Active
DSH330226J	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Orthopaedics at Chili	2115 Chili Avenue	Rochester	NY	Active
DSH330226K	Child	DSH	UNITY HOSPITAL OF ROCHESTER	UMG PFT LAB LIND OAK	10 HAGEN DRIVE	Rochester	NY	Active
DSH330226L	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Comprehensive OP Rehab	2655 RIDGEWAY AVE	Rochester	NY	Active
DSH330226M	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Long Pond / Unity Infectious Disease	1561 LONG POND RD. SUITE 220	Rochester	NY	Active
DSH330226N	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Brockport / Unity Family Medicine at Brockport	6668 Fourth Section Road	Brockport	NY	Active
DSH330226P	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Unity Dialysis at Spencerport	4 Land Re Way	Spencerport	NY	Active
DSH330226Q	Child	DSH	UNITY HOSPITAL OF ROCHESTER	Chili / Unity Dialysis at Chili	3379 Chili Avenue	Rochester	NY	Active
DSH330226R	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity OB/GYN at Parkway	500 ISLAND COTTAGE RD	ROCHESTER	NY	Active
DSH330226S	Child	DSH	UNITY HOSPITAL OF ROCHESTER	RIDGEWAY / Unity Internal Medicine at Ridgeway	120 Erie Canal Drive	ROCHESTER	NY	Active
DSH330226T	Child	DSH	UNITY HOSPITAL OF ROCHESTER	BROCKPORT / Unity OB/GYN at Brockport	6668 4TH SECTION RD	BROCKPORT	NY	Active
DSH330226U	Child	DSH	UNITY HOSPITAL OF ROCHESTER	SPENCERPORT / Unity Family Medicine at Spencerport	4 LAND RE WAY	SPENCERPORT	NY	Active
DSH330226V	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Chemical Dependency Brighton Clinic	2000 WINTON RD S	ROCHESTER	NY	Active
DSH330226W	Child	DSH	UNITY HOSPITAL OF ROCHESTER	RIDGEWAY / Unity OB/GYN at Ridgeway	2655 RIDGEWAY AVE	ROCHESTER	NY	Active
DSH330226X	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Unity Walk-In Care Center	65 GENESEE ST	ROCHESTER	NY	Active
DSH330226Y	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / St. Mary's Radiology	89 GENESEE ST	ROCHESTER	NY	Terminated
DSH330226Z	Child	DSH	UNITY HOSPITAL OF ROCHESTER	THE UNITY HOSPITAL OF ROCHESTER / Blended Case Management	89 GENESEE ST	ROCHESTER	NY	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/29/2023 4:45:43 PM	8/28/2024 1:31:48 PM	8/28/2024 1:31 PM
Details	Last Recertification Date	Update	Recertification	9/20/2022 7:40:25 AM	8/29/2023 4:45:43 PM	8/29/2023 4:45 PM
Contacts	Primary Contact	Update	PC Change Request	Kinter, Karen M Vice President of Specialty Revenue Programs Rochester Regional 5853683537	Scardino, Robert Michael 340B Pharmacy System Manager RRH 5853196750	8/21/2023 2:35 PM
Contacts	Authorizing Official	Update	Change Request	Thomas, Hugh Executive Vice President, Chief Administrative Officer Rochester Regional Health 5859224941	Bishop, Shawn Vice President, RRH Revenue & Reimbursement Rochester Regional Health 5859220056	8/1/2023 12:54 PM
Addresses	Shipping Address	Insert	Recertification		St. Mary’s Campus ATTN: Pharmacy Department 55-75 Genesee Street Rochester, NY 14611	9/20/2022 7:40 AM
Details	Last Recertification Date	Update	Recertification	9/8/2020 9:20:03 AM	9/20/2022 7:40:25 AM	9/20/2022 7:40 AM
Contacts	Primary Contact	Update	Profile Change Request	Kinter, Karen M 340B Program Director Rochester General Hospital 5853683537	Kinter, Karen M Vice President of Specialty Revenue Programs Rochester Regional 5853683537	7/29/2022 8:15 AM
Contacts	Authorizing Official	Update	Profile Change Request	Thomas, Hugh Executive Vice President, Chief Administrative Officer Unity Hospital 5859224941	Thomas, Hugh Executive Vice President, Chief Administrative Officer Rochester Regional Health 5859224941	7/8/2022 12:36 PM
Contacts	Signed By	Update	Profile Change Request	Thomas, Hugh Executive Vice President, Chief Administrative Officer Unity Hospital 5859224941	Thomas, Hugh Executive Vice President, Chief Administrative Officer Rochester Regional Health 5859224941	7/8/2022 12:36 PM
Dates	Last Date That 340B Drugs Purchased	Update	COVID-19 Reinstatement	9/1/2021 12:00:00 AM		4/14/2022 5:47 PM
Details	State	Update	COVID-19 Reinstatement	Terminated	Active	4/14/2022 5:47 PM
Dates	Start Date	Update	COVID-19 Reinstatement	7/1/2016 12:00:00 AM	3/15/2022 12:00:00 AM	4/14/2022 5:47 PM
Terminations	Termination Date	Update	COVID-19 Reinstatement	9/1/2021 12:00:00 AM		4/14/2022 5:47 PM
Terminations	Termination Effective Date	Update	COVID-19 Reinstatement	9/1/2021 12:00:00 AM		4/14/2022 5:47 PM
Terminations	Termination Reason	Update	COVID-19 Reinstatement	Change of hospital entity type		4/14/2022 5:47 PM
Dates	Last Date That 340B Drugs Purchased	Update	OPA Edit Termination Info	10/1/2021 12:00:00 AM	9/1/2021 12:00:00 AM	9/1/2021 1:01 PM
Details	State	Update	OPA Edit Termination Info	To Be Terminated	Terminated	9/1/2021 1:01 PM
Terminations	Termination Date	Update	OPA Edit Termination Info	10/1/2021 12:00:00 AM	9/1/2021 12:00:00 AM	9/1/2021 1:01 PM
Terminations	Termination Effective Date	Update	OPA Edit Termination Info	10/1/2021 12:00:00 AM	9/1/2021 12:00:00 AM	9/1/2021 1:01 PM
Terminations	Termination Reason	Update	OPA Edit Termination Info	Change of covered entity type	Change of hospital entity type	9/1/2021 1:01 PM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		10/1/2021 12:00:00 AM	9/1/2021 12:22 PM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	9/1/2021 12:22 PM
Terminations	Termination Date	Update	Hospital Type Change Request		10/1/2021 12:00:00 AM	9/1/2021 12:22 PM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		10/1/2021 12:00:00 AM	9/1/2021 12:22 PM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	9/1/2021 12:22 PM
Addresses	Shipping Address	Insert	Change Request		Unity Hospital of Rochester, St. Mary's Campus 75 Genesee St Rochester, NY 14611	4/12/2021 8:10 AM
Contacts	Primary Contact	Update	New Registration	Kinter, Karen 340B Program Director Rochester General Hospital 5853683537	Kinter, Karen M 340B Program Director Rochester General Hospital 5853683537	10/11/2020 1:47 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	02728045 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1186429 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	01372403 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	01535840 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03002917 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03002926 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03002935 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03002953 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03061061 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03168141 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03273443 (NY)		9/8/2020 9:20 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	03530132 (NY)		9/8/2020 9:20 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1336366822	9/8/2020 9:20 AM
Medicaid Billing	NPI: State	Insert	Recertification		NY	9/8/2020 9:20 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1336366822 ( )		9/8/2020 9:20 AM
Contacts	Primary Contact	Update	Recertification	Adams, Robert Assistant Director of Pharmacy Unity Hospital 5857237837	Kinter, Karen 340B Program Director Rochester General Hospital 5853683537	9/8/2020 9:20 AM
Details	Last Recertification Date	Update	Recertification	9/1/2019 2:23:34 PM	9/8/2020 9:20:03 AM	9/8/2020 9:20 AM
Details	Last Recertification Date	Update	Recertification	9/11/2018 4:52:56 PM	9/1/2019 2:23:34 PM	9/1/2019 2:23 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1457395766 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1235287525 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1255489183 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1417227570 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1427282417 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1508195306 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1689891178 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1699824847 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1700934668 ( )		2/28/2019 7:51 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1760421713 ( )		2/28/2019 7:51 AM
Addresses	Shipping Address	Insert	Change Request		Park Ridge Hospital, Inc - Genesee Campus Pharmacy 89 Genesee Street Rochester, NY 14611	10/9/2018 11:59 AM
Addresses	Shipping Address	Delete	Change Request	Unity Hospital - St. Mary's Campus Inpatient Pharmacy 89 Genesee Street Rochester, NY 14611		10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		02728045	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1186429	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		01372403	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		01535840	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03002917	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03002926	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03002935	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03002953	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03061061	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03168141	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03273443	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		03530132	10/9/2018 11:59 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1457395766	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1235287525	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1255489183	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1417227570	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1427282417	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1508195306	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1689891178	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1699824847	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1700934668	10/9/2018 11:59 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1760421713	10/9/2018 11:59 AM
Details	Entity Subname	Update	Change Request	THE UNITY HOSPITAL SYSTEM / Unity Mental Health's Greece Clinic	THE UNITY HOSPITAL SYSTEM / Unity Mental Health Greece Clinic	10/9/2018 11:59 AM
Details	Last Recertification Date	Update	Recertification	11/5/2017 10:34:54 AM	9/11/2018 4:52:56 PM	9/11/2018 4:52 PM
Details	Last Recertification Date	Update	Recertification	8/18/2016 12:00:00 AM	11/5/2017 10:34:54 AM	11/5/2017 10:34 AM
Contacts	Authorizing Official	Update		Thomas, Hugh Executive Vice President, Chief Administrative Officer 5859224941	Thomas, Hugh Executive Vice President, Chief Administrative Officer Unity Hospital 5859224941	10/16/2017 8:49 AM
Contacts	Signed By	Update		Thomas, Hugh Executive Vice President, Chief Administrative Officer 5859224941	Thomas, Hugh Executive Vice President, Chief Administrative Officer Unity Hospital 5859224941	10/16/2017 8:49 AM
Contacts	Primary Contact	Update		Adams, Robert Assistant Director of Pharmacy 5857237837	Adams, Robert Assistant Director of Pharmacy Unity Hospital 5857237837	10/10/2017 2:02 PM
Contacts	Authorizing Official	Insert			Thomas, Hugh Executive Vice President, Chief Administrative Officer 5859224941	4/28/2017 3:53 PM
Contacts	Signed By	Insert			Thomas, Hugh Executive Vice President, Chief Administrative Officer 5859224941	4/28/2017 3:53 PM
Contacts	Primary Contact	Insert			Adams, Robert Assistant Director of Pharmacy 5857237837	4/28/2017 3:53 PM
Addresses	Main Address	Insert			100 PINEWILD DR STE 2A ROCHESTER, NY 14606	4/28/2017 3:52 PM
Addresses	Billing Address	Insert			Unity Hospital P.O.BOX 10460 Rochester, NY 14610	4/28/2017 3:52 PM
Addresses	Shipping Address	Insert			Unity Hospital - St. Mary's Campus Inpatient Pharmacy 89 Genesee Street Rochester, NY 14611	4/28/2017 3:52 PM
Details	Last Recertification Date	Update			8/18/2016 12:00:00 AM	8/18/2016 8:08 AM
Dates	Participating Approval Date	Update			5/10/2016 12:00:00 AM	5/10/2016 12:48 PM
Details	State	Update		Pending	Active	5/10/2016 12:48 PM
Dates	Start Date	Update			7/1/2016 12:00:00 AM	5/10/2016 12:48 PM
Details	Entity Subname	Update		THE UNITY HOSPITAL SYSTEM / Unity Mental Health’s Greece Clinic	THE UNITY HOSPITAL SYSTEM / Unity Mental Health's Greece Clinic	5/10/2016 11:56 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_60324	DSH330226AN	5/6/2016 9:45 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_60324	4/14/2016 3:26 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/14/2016 3:26 PM
Medicaid Billing	Medicaid: Number	Insert			00378721	4/14/2016 3:26 PM
Medicaid Billing	Medicaid: State	Insert			NY	4/14/2016 3:26 PM
Medicaid Billing	NPI: Number	Insert			1336366822	4/14/2016 3:26 PM
Details	Last Recertification Date	Insert				4/14/2016 3:26 PM
Details	Grant Number	Insert				4/14/2016 3:26 PM
Details	340B ID	Insert				4/14/2016 3:26 PM
Details	Is Authorizing Official EHB Data	Insert				4/14/2016 3:26 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/14/2016 3:26 PM
Details	Medicare Provider Number	Insert			330226	4/14/2016 3:26 PM
Details	Entity Name	Insert			UNITY HOSPITAL OF ROCHESTER	4/14/2016 3:26 PM
Details	Program Code	Insert			DSH	4/14/2016 3:26 PM
Details	Entity Subname	Insert			THE UNITY HOSPITAL SYSTEM / Unity Mental Health’s Greece Clinic	4/14/2016 3:26 PM
Dates	Participating Approval Date	Insert				4/14/2016 3:26 PM
Details	State	Insert			Pending	4/14/2016 3:26 PM
Dates	Registration Date	Insert			4/14/2016 12:00:00 AM	4/14/2016 3:26 PM
Dates	Signed By Date	Insert			4/14/2016 12:00:00 AM	4/14/2016 3:26 PM
Dates	Start Date	Insert				4/14/2016 3:26 PM
Terminations	Termination Comments	Insert				4/14/2016 3:26 PM
Terminations	Termination Date	Insert				4/14/2016 3:26 PM
Terminations	Termination Effective Date	Insert				4/14/2016 3:26 PM
Terminations	Termination Reason	Insert				4/14/2016 3:26 PM