| Details | State | Update | | To Be Terminated | Terminated | 1/1/2025 12:01 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | Termination Request | | 12/3/2024 12:00:00 AM | 12/9/2024 7:58 AM |
| Details | State | Update | Termination Request | Active | To Be Terminated | 12/9/2024 7:58 AM |
| Terminations | Termination Comments | Update | Termination Request | | The cost report was filed late on 12/2/24 and not provided to me until this morning (12/3/24). | 12/9/2024 7:58 AM |
| Terminations | Termination Date | Update | Termination Request | | 1/1/2025 12:00:00 AM | 12/9/2024 7:58 AM |
| Terminations | Termination Effective Date | Update | Termination Request | | 12/2/2024 12:00:00 AM | 12/9/2024 7:58 AM |
| Terminations | Termination Reason | Update | Termination Request | | DSH percentage below statutory minimum | 12/9/2024 7:58 AM |
| Details | Last Recertification Date | Update | Recertification | 8/25/2023 7:03:12 AM | 8/14/2024 7:31:22 AM | 8/14/2024 7:31 AM |
| Details | Last Recertification Date | Update | Recertification | 8/24/2022 7:14:42 AM | 8/25/2023 7:03:12 AM | 8/25/2023 7:03 AM |
| Details | Last Recertification Date | Update | Recertification | 9/2/2021 7:12:50 AM | 8/24/2022 7:14:42 AM | 8/24/2022 7:14 AM |
| Contacts | Authorizing Official | Update | Change Request | Prunoske, Mark F
SVP/CFO
Nicholas H. Noyes Memorial Hospital
5853354306 | Prunoske, Mark F
SVP/CFO
Nicholas H. Noyes Memorial Hospital
5853354306 | 10/13/2021 10:57 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | Prunoske, Mark F
SVP/CFO
Nicholas H. Noyes Memorial Hospital
5853354339 | Prunoske, Mark F
SVP/CFO
Nicholas H. Noyes Memorial Hospital
5853354306 | 9/2/2021 7:18 AM |
| Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 9/2/2021 7:12 AM |
| Medicaid Billing | Medicaid: Number | Insert | Recertification | | 0014060920001 | 9/2/2021 7:12 AM |
| Medicaid Billing | Medicaid: State | Insert | Recertification | | PA | 9/2/2021 7:12 AM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1861779449 | 9/2/2021 7:12 AM |
| Medicaid Billing | NPI: State | Insert | Recertification | | PA | 9/2/2021 7:12 AM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1982625661 | 9/2/2021 7:12 AM |
| Medicaid Billing | NPI: State | Insert | Recertification | | PA | 9/2/2021 7:12 AM |
| Details | Last Recertification Date | Update | Recertification | 8/20/2020 3:56:57 PM | 9/2/2021 7:12:50 AM | 9/2/2021 7:12 AM |
| Contacts | Primary Contact | Update | Change Request | Lees, Katy
Director, 340B Policy and Business Strategy
UR Medicine
5857035169 | Lees, Katy
Director, 340B Policy and Business Strategy
UR Medicine
5857035169-5855964002 | 12/10/2020 8:06 AM |
| Contacts | Authorizing Official | Update | Change Request | Maslyn, Jay
CFO
Nicholas Noyes Memorial Hospital
5853354306 | Prunoske, Mark F
SVP/CFO
Nicholas H. Noyes Memorial Hospital
5853354339 | 9/7/2020 12:53 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Lees, Katy
Director, 340B Policy and Business Strategy
UR Medicine
5857855154 | Lees, Katy
Director, 340B Policy and Business Strategy
UR Medicine
5857035169 | 9/3/2020 12:10 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Lees, Katy
Associate Director of Pharmacy, 340B Policy and Business Strategy
UR Medicine
5857855154 | Lees, Katy
Director, 340B Policy and Business Strategy
UR Medicine
5857855154 | 8/21/2020 9:29 AM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1861779449 ( ) | | 8/20/2020 3:56 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1982625661 | 8/20/2020 3:56 PM |
| Medicaid Billing | NPI: State | Insert | Recertification | | NY | 8/20/2020 3:56 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1861779449 | 8/20/2020 3:56 PM |
| Medicaid Billing | NPI: State | Insert | Recertification | | NY | 8/20/2020 3:56 PM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1982625661 ( ) | | 8/20/2020 3:56 PM |
| Details | Last Recertification Date | Update | Recertification | 9/5/2019 6:58:04 AM | 8/20/2020 3:56:57 PM | 8/20/2020 3:56 PM |
| Contacts | Primary Contact | Update | Profile Change Request | Lees, Katy
340B Business Manager
UR Medicine
5857855154 | Lees, Katy
Associate Director of Pharmacy, 340B Policy and Business Strategy
UR Medicine
5857855154 | 10/28/2019 11:14 AM |
| Details | Entity Subname | Update | Change Request | Noyes Physician Clinic at Genesee / Regional Orthopedics | Noyes Physician Clinic at Geneseo / Regional Orthopedics | 10/3/2019 1:51 PM |
| Addresses | Shipping Address | Insert | Recertification | | Noyes Memorial Hospital
111 Clara Barton Street
Dansville, NY 14437 | 9/5/2019 6:58 AM |
| Details | Last Recertification Date | Update | Recertification | 9/6/2018 8:25:05 AM | 9/5/2019 6:58:04 AM | 9/5/2019 6:58 AM |
| Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 7/11/2019 11:23 AM |
| Medicaid Billing | Medicaid: Number | Insert | Change Request | | 3612351 | 7/11/2019 11:23 AM |
| Medicaid Billing | Medicaid: State | Insert | Change Request | | NY | 7/11/2019 11:23 AM |
| Medicaid Billing | NPI: Number | Insert | Change Request | | 1861779449 | 7/11/2019 11:23 AM |
| Details | Last Recertification Date | Update | Recertification | 11/19/2017 9:04:47 AM | 9/6/2018 8:25:05 AM | 9/6/2018 8:25 AM |
| Details | Last Recertification Date | Update | Recertification | 10/25/2017 2:08:52 PM | 11/19/2017 9:04:47 AM | 11/19/2017 9:04 AM |
| Contacts | Primary Contact | Update | Recertification | Maslyn, Jay
CFO
5853354306 | Lees, Katy
340B Business Manager
UR Medicine
5857855154 | 10/25/2017 2:08 PM |
| Details | Last Recertification Date | Update | Recertification | | 10/25/2017 2:08:52 PM | 10/25/2017 2:08 PM |
| Contacts | Authorizing Official | Update | | Maslyn, Jay
CFO
5853354306 | Maslyn, Jay
CFO
Nicholas Noyes Memorial Hospital
5853354306 | 10/23/2017 8:15 AM |
| Contacts | Signed By | Update | | Maslyn, Jay
CFO
5853354306 | Maslyn, Jay
CFO
Nicholas Noyes Memorial Hospital
5853354306 | 10/23/2017 8:15 AM |
| Addresses | Main Address | Insert | | |
50 E. South Street
Geneseo, NY 14454 | 7/25/2017 12:45 PM |
| Addresses | Billing Address | Insert | | | Nicholas Noyes Hospital
111 Clara Barton Street
Dansville, NY 14437 | 7/25/2017 12:45 PM |
| Contacts | Authorizing Official | Insert | | | Maslyn, Jay
CFO
5853354306 | 7/25/2017 12:45 PM |
| Contacts | Primary Contact | Insert | | | Maslyn, Jay
CFO
5853354306 | 7/25/2017 12:45 PM |
| Contacts | Signed By | Insert | | | Maslyn, Jay
CFO
5853354306 | 7/25/2017 12:45 PM |
| Details | State | Update | | Approved | Active | 7/25/2017 12:45 PM |
| Dates | Participating Approval Date | Update | | | 7/25/2017 12:00:00 AM | 7/25/2017 12:41 PM |
| Details | State | Update | | Pending | Approved | 7/25/2017 12:41 PM |
| Dates | Start Date | Update | | | 10/1/2017 12:00:00 AM | 7/25/2017 12:41 PM |
| Details | Entity Subname | Update | | Noyes Physician Clinic at Geneseo / Genesee Regional Orthopedics | Noyes Physician Clinic at Genesee / Regional Orthopedics | 7/13/2017 3:05 PM |
| Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG_78467 | DSH330238G | 7/13/2017 3:04 PM |
| Details | Entity Subname | Update | | Noyes Physician Clinic at Geneseo / Noyes Genesee Regional Orthopedics | Noyes Physician Clinic at Geneseo / Genesee Regional Orthopedics | 7/13/2017 3:04 PM |
| Details | 340B ID | Update | | | OUTPATIENT_ONLINE_REG_78467 | 7/13/2017 2:30 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 7/13/2017 2:30 PM |
| Medicaid Billing | Medicaid: Number | Insert | | | 00354476 | 7/13/2017 2:30 PM |
| Medicaid Billing | Medicaid: State | Insert | | | NY | 7/13/2017 2:30 PM |
| Medicaid Billing | NPI: Number | Insert | | | 1982625661 | 7/13/2017 2:30 PM |
| Details | Last Recertification Date | Insert | | | | 7/13/2017 2:30 PM |
| Details | Grant Number | Insert | | | | 7/13/2017 2:30 PM |
| Details | 340B ID | Insert | | | | 7/13/2017 2:30 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 7/13/2017 2:30 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 7/13/2017 2:30 PM |
| Details | Medicare Provider Number | Insert | | | 330238 | 7/13/2017 2:30 PM |
| Details | Entity Name | Insert | | | NICHOLAS H. NOYES MEMORIAL HOSPITAL | 7/13/2017 2:30 PM |
| Details | Program Code | Insert | | | DSH | 7/13/2017 2:30 PM |
| Details | Entity Subname | Insert | | | Noyes Physician Clinic at Geneseo / Noyes Genesee Regional Orthopedics | 7/13/2017 2:30 PM |
| Dates | Participating Approval Date | Insert | | | | 7/13/2017 2:30 PM |
| Details | State | Insert | | | Pending | 7/13/2017 2:30 PM |
| Dates | Registration Date | Insert | | | 7/13/2017 12:00:00 AM | 7/13/2017 2:30 PM |
| Dates | Signed By Date | Insert | | | 7/13/2017 12:00:00 AM | 7/13/2017 2:30 PM |
| Dates | Start Date | Insert | | | | 7/13/2017 2:30 PM |
| Terminations | Termination Comments | Insert | | | | 7/13/2017 2:30 PM |
| Terminations | Termination Date | Insert | | | | 7/13/2017 2:30 PM |
| Terminations | Termination Effective Date | Insert | | | | 7/13/2017 2:30 PM |
| Terminations | Termination Reason | Insert | | | | 7/13/2017 2:30 PM |