Covered Entity Details

RRC330125-40 ROCHESTER GENERAL HOSPITAL (Terminated) - information as of 6/2/2025 8:32:50 AM

Main Details

Name

ROCHESTER GENERAL HOSPITAL

Subdivision Name

RMG BAY CREEK PEDS - Pediatrics

Type

Rural Referral Center

Rural

340B ID

RRC330125-40

Medicare Provider Number

330125

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

1/12/2019

Participating Start Date

4/1/2019

Participating Approval Date

2/21/2019

Last Recertification Date

Termination Date
Termination Reason

10/1/2019
Change of covered entity type

Contacts

Authorizing Official

Rochester Regional Health
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941

Primary Contact

Rochester Regional
Karen M Kinter, Vice President of Specialty Revenue Programs
(585) 368-3537

Addresses

Street Address

2000 Empire Blvd
Webster, NY 14580

Billing Address
Same as Street Address

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	3007054
		1255360517,1760557656,1356412712

Shipping Addresses

Shipping Address 1

Rochester General Hospital
1425 Portland Avenue
Att: 340B Pharmacy
Rochester, NY 16621

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
RRC330125-01	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH OT @ IRONDEQUOIT - OT	1381 East Ridge Road	Rochester	NY	Terminated
RRC330125-02	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH SCHI @ LINDEN OAKS - Cardio	30 Hagen Drive	Rochester	NY	Terminated
RRC330125-03	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH MAMMO @ BAY CREEK - Mammography	2000 Empire Blvd	Webster	NY	Terminated
RRC330125-04	Child	RRC	ROCHESTER GENERAL HOSPITAL	BHN GMHC CHILD & YOUTH - Behavioral Health	224 ALEXANDER STREET	ROCHESTER	NY	Terminated
RRC330125-05	Child	RRC	ROCHESTER GENERAL HOSPITAL	BHN GMHC ADULT CLINIC - Mental Health	224 ALEXANDER STREET	Rochester	NY	Terminated
RRC330125-06	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG SODUS INT MED - Internal Medicine	6692 Middle Road	Sodus	NY	Terminated
RRC330125-07	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RMG LONG POND INT MED	2350 RIDGEWAY AVE	ROCHESTER	NY	Terminated
RRC330125-08	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH PRO DOM NEPHRO - Nephrology	370 East Ridge Road	Rochester	NY	Terminated
RRC330125-09	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RGH NEUROLOGY @ MOB	1415 PORTLAND AVE	ROCHESTER	NY	Terminated
RRC330125-10	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH SCHI @ CLINTON - Heart	2365 South Clinton Avenue	Rochester	NY	Terminated
RRC330125-11	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG WILLIAMSON FAMILY - Primary Care	4425 Old Ridge Road	Williamson	NY	Terminated
RRC330125-12	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - Lyons Healh Center	12 LEACH RD	LYONS	NY	Terminated
RRC330125-13	Child	RRC	ROCHESTER GENERAL HOSPITAL	RRH FAMILY MEDICINE AT RIT - Family Medicine	181 LOMB MEMORIAL DR	ROCHESTER	NY	Terminated
RRC330125-14	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH ST ANN'S WOUNDCARE - woundcare	1500 Portland Avenue	Rochester	NY	Terminated
RRC330125-15	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG SODUS PEDIATRICS - Pediatrics	6692 Middle Road	Sodus	NY	Terminated
RRC330125-16	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH MOB RADIOLOGY - Radiology	1415 Portland Avenue	Rochester	NY	Terminated
RRC330125-17	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - Diabetes	12 LEACH RD	LYONS	NY	Terminated
RRC330125-18	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH LINDEN OAKS DEXA - Radiology	10 Hagen Drive	Rochester	NY	Terminated
RRC330125-19	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RMG DERM NIM	1208 DRIVING PARK AVE	NEWARK	NY	Terminated
RRC330125-20	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG NORTHRIDGE MEDICAL - Primary Care	1338 East Ridge Road	Rochester	NY	Terminated
RRC330125-21	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG ASTHMA ALLERGY GRC - Allergy, Imm and Asthma	2300 West Ridge Road	Rochester	NY	Terminated
RRC330125-22	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG TWC AT NEWARK - OB/GYN	1250 Driving Park Avenue	Newark	NY	Terminated
RRC330125-23	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH RAD ONC AT LINDEN - Rad Oncology	20 Hagen Drive	Rochester	NY	Terminated
RRC330125-24	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RGH RAD @ BAY CREEK	2000 EMPIRE BLVD	WEBSTER	NY	Terminated
RRC330125-25	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG DERM SIM - Dermatology	6692 Middle Road	Sodus	NY	Terminated
RRC330125-26	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG ALLERGY IMM AT LO - Air Allergy / Immunology	10 Hagen Drive	Rochester	NY	Terminated
RRC330125-27	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RGH UROLOGY @ NWH	1202 DRIVING PARK AVE	NEWARK	NY	Terminated
RRC330125-28	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG TWC ANTENATAL NWH - Antenatal	1250 Driving Park Avenue	Newark	NY	Terminated
RRC330125-29	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG GIM AT PORTLAND - Primary Care	1299 Portland Ave	Rochester	NY	Terminated
RRC330125-30	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH PT @ IRONDEQUOIT - PT	1381 East Ridge Road	Rochester	NY	Terminated
RRC330125-31	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RGH PAIN CENTER	1415 PORTLAND AVE	ROCHESTER	NY	Terminated
RRC330125-32	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - Oral Surgery	1455 E RIDGE RD	ROCHESTER	NY	Terminated
RRC330125-33	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH MED ONC AT LINDEN - ONC	20 Hagen Drive	Rochester	NY	Terminated
RRC330125-34	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - PENN FAIR PEDS	2067 FAIRPOINT NINE MILE RD	PENFIELD	NY	Terminated
RRC330125-35	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG LINDEN MEDICAL GRP - Primary Care	30 Hagen Drive	Rochester	NY	Terminated
RRC330125-36	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG BAY CREEK MEDICAL - Primary Care	2000 Empire Blvd	Webster	NY	Terminated
RRC330125-37	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RMG ALRGY IMM RHEUM	222 ALEXANDER ST	ROCHESTER	NY	Terminated
RRC330125-38	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RMG RIDGEWAY FAMILY	2350 RIDGEWAY AVE	ROCHESTER	NY	Terminated
RRC330125-39	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - GERIATRIC	1415 PORTLAND AVE	ROCHESTER	NY	Terminated
RRC330125-40	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG BAY CREEK PEDS - Pediatrics	2000 Empire Blvd	Webster	NY	Terminated
RRC330125-41	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RMG PENN FAIR PC	2200 PENFIELD RD	PENFIELD	NY	Terminated
RRC330125-42	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - Opthamology	1455 E RIDGE RD	ROCHESTER	NY	Terminated
RRC330125-43	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH PAIN CLINIC LINDEN - Pain Management	360 Linden Oaks Drive	Rochester	NY	Terminated
RRC330125-44	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG MIDWIFE BAYCREEK - OBGYN	2000 Empire Blvd	Webster	NY	Terminated
RRC330125-45	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG ORTHO AT BAYCREEK - Ortho	2000 Empire Blvd	Webster	NY	Terminated
RRC330125-46	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG WILLIAMSON PEDS - Primary Care	4425 Old Ridge Road	Williamson	NY	Terminated
RRC330125-47	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH HEM ONC @ LO - hematology oncology	20 Hagen Drive	Rochester	NY	Terminated
RRC330125-48	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG GANANDA FAMILY - Primary Care	1200 Fairway Seven	Macedon	NY	Terminated
RRC330125-49	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG CENTER FOR DERM - Derm	20 Hagen Drive	Rochester	NY	Terminated
RRC330125-50	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG LP ADULT WEEKEND - adult care	2350 Ridgeway Avenue	Rochester	NY	Terminated
RRC330125-51	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG WHITE PINES MED - Primary Care	370 East Ridge Road	Rochester	NY	Terminated
RRC330125-52	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH RAD HENRIETTA - Radiology	50 Middle Road	Henrietta	NY	Terminated
RRC330125-53	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG VEIN CARE LINDEN - Vein Care	20 Hagen Drive	Rochester	NY	Terminated
RRC330125-54	Child	RRC	ROCHESTER GENERAL HOSPITAL	GMH GMHC PROS - Pros	224 Alexander Street	Rochester	NY	Terminated
RRC330125-55	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH RAD @ LINDEN OAKS - Radiology	360 Linden Oaks Drive	Rochester	NY	Terminated
RRC330125-56	Child	RRC	ROCHESTER GENERAL HOSPITAL	RMG RHEUM INFUSION CTR - AIR Infusion	10 Hagen Drive	Rochester	NY	Terminated
RRC330125-57	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - RGH RDI RADIOLOGY MRI	1415 PORTLAND AVE	ROCHESTER	NY	Terminated
RRC330125-58	Child	RRC	ROCHESTER GENERAL HOSPITAL	ROCHESTER GENERAL HOSPITAL - Allergy, Immunology and Rheumatology (AIR)	12 LEACH RD	LYONS	NY	Terminated
RRC330125-59	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH PT @ 360 LINDEN - Physical Therapy	360 Linden Oaks Drive	Rochester	NY	Terminated
RRC330125-60	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH PT AT MIDTOWN - PT	210 East Highland Drive	Rochester	NY	Terminated
RRC330125-61	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH OT @ 360 LINDEN - Occ Therapy	360 Linden Oaks Drive	Rochester	NY	Terminated
RRC330125-62	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH DIALYSIS-BAYCREEK - Dialysis	2010 Empire Blvd	Webster	NY	Terminated
RRC330125-63	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH HEMODIALYSIS - HEMODIALYSIS	370 East Ridge Road	Rochester	NY	Terminated
RRC330125-64	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH HOME DIALYSIS - Dialysis	370 East Ridge Road	Rochester	NY	Terminated
RRC330125-66	Child	RRC	ROCHESTER GENERAL HOSPITAL	RGH SCHI MOB - Heart insitiute	1415 Portland Ave	Rochester	NY	Terminated
RRC330125-67	Child	RRC	ROCHESTER GENERAL HOSPITAL	VASC SURGERY - SURGERY	1445 Portland Ave	Rochester	NY	Terminated
RRC330125-68	Child	RRC	ROCHESTER GENERAL HOSPITAL	Newark Pediatrics - Pediatrics	1200 Driving Park	Newark	NY	Terminated
RRC330125-69	Child	RRC	ROCHESTER GENERAL HOSPITAL	GI AT NEWARK - GI	1304 Driving Park Ave.	Newark	NY	Terminated
RRC330125-70	Child	RRC	ROCHESTER GENERAL HOSPITAL	DCRC AT BAYCREEK - Diabetes and Endocrinolgy	2000 Empire Blvd	Webster	NY	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
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
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
Contacts	Primary Contact	Update	Profile Change Request	Kinter, Karen 340B Program Director Rochester General Hospital 5859226735	Kinter, Karen 340B Program Director Rochester General Hospital 5853683537	8/21/2020 4:31 PM
Details	State	Update		To Be Terminated	Terminated	10/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		10/1/2019 12:00:00 AM	7/23/2019 10:23 AM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	7/23/2019 10:23 AM
Terminations	Termination Date	Update	Hospital Type Change Request		10/1/2019 12:00:00 AM	7/23/2019 10:23 AM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		10/1/2019 12:00:00 AM	7/23/2019 10:23 AM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	7/23/2019 10:23 AM
Details	State	Update		Approved	Active	4/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Thomas, Hugh Executive Vice President, Chief Administrative Officer Unity Hospital 5859224941	2/21/2019 9:28 AM
Details	340B ID	Update	New Registration		RRC330125-40	2/21/2019 9:28 AM
Details	Entity Subname	Update	New Registration	RMG BAY CREEK PEDS	RMG BAY CREEK PEDS - Pediatrics	2/21/2019 9:28 AM
Dates	Participating Approval Date	Update	New Registration		2/21/2019 9:28:34 AM	2/21/2019 9:28 AM
Details	State	Update	New Registration	Pending	Approved	2/21/2019 9:28 AM
Dates	Signed By Date	Update	New Registration		1/15/2019 2:16:55 PM	2/21/2019 9:28 AM
Dates	Start Date	Update	New Registration		4/1/2019 12:00:00 AM	2/21/2019 9:28 AM
Addresses	Main Address	Insert	New Registration		2000 Empire Blvd Webster, NY 14580	1/12/2019 10:53 AM
Addresses	Shipping Address	Insert	New Registration		Rochester General Hospital 1425 Portland Avenue Att: 340B Pharmacy Rochester, NY 16621	1/12/2019 10:53 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/12/2019 10:53 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		3007054	1/12/2019 10:53 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	1/12/2019 10:53 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1255360517	1/12/2019 10:53 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1760557656	1/12/2019 10:53 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1356412712	1/12/2019 10:53 AM
Contacts	Authorizing Official	Insert	New Registration		Thomas, Hugh Executive Vice President, Chief Administrative Officer Unity Hospital 5859224941	1/12/2019 10:53 AM
Contacts	Primary Contact	Insert	New Registration		Kinter, Karen 340B Program Director Rochester General Hospital 5859226735	1/12/2019 10:53 AM
Details	Last Recertification Date	Insert	New Registration			1/12/2019 10:53 AM
Details	Grant Number	Insert	New Registration			1/12/2019 10:53 AM
Details	340B ID	Insert	New Registration			1/12/2019 10:53 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/12/2019 10:53 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/12/2019 10:53 AM
Details	Medicare Provider Number	Insert	New Registration		330125	1/12/2019 10:53 AM
Details	Entity Name	Insert	New Registration		ROCHESTER GENERAL HOSPITAL	1/12/2019 10:53 AM
Details	Program Code	Insert	New Registration		RRC	1/12/2019 10:53 AM
Details	Entity Subname	Insert	New Registration		RMG BAY CREEK PEDS	1/12/2019 10:53 AM
Dates	Participating Approval Date	Insert	New Registration			1/12/2019 10:53 AM
Details	State	Insert	New Registration		Pending	1/12/2019 10:53 AM
Dates	Registration Date	Insert	New Registration		1/12/2019 10:53:16 AM	1/12/2019 10:53 AM
Dates	Signed By Date	Insert	New Registration			1/12/2019 10:53 AM
Dates	Start Date	Insert	New Registration			1/12/2019 10:53 AM
Terminations	Termination Comments	Insert	New Registration			1/12/2019 10:53 AM
Terminations	Termination Date	Insert	New Registration			1/12/2019 10:53 AM
Terminations	Termination Effective Date	Insert	New Registration			1/12/2019 10:53 AM
Terminations	Termination Reason	Insert	New Registration			1/12/2019 10:53 AM