Covered Entity Details

DSH330078AN SISTERS OF CHARITY HOSPITAL (Active) - information as of 5/9/2025 10:44:55 PM

Main Details

Name

SISTERS OF CHARITY HOSPITAL

Subdivision Name

MERCY COMPREHENSIVE CARE CENTER - Mercy Comprehensive Care Ctr - Adult

Type

Disproportionate Share Hospital

Rural

340B ID

DSH330078AN

Medicare Provider Number

330078

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/6/2021

Participating Start Date

4/1/2021

Participating Approval Date

3/3/2021

Last Recertification Date

9/3/2024

Contacts

Authorizing Official

Catholic Health System
Michael Osborne, Vice President, Finance
(716) 828-2011

Primary Contact

Catholic Health System
Selena Holody, Analyst, 340B Program
(716) 270-6981

Addresses

Street Address

397 LOUISIANA ST
BUFFALO, NY 14204-2275

Billing Address

Sisters of Charity Hospital C/O Catholic Health
144 Genesee Street
4th Floor
Buffalo, NY 14203

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	03075789	1790727543

Shipping Addresses

Shipping Address 1

SISTERS OF CHARITY HOSPITAL
2157 Main Street
Buffalo, NY 14214

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Last Updated On
Contract Detail	31ST & 3RD PHARMACY INC	D/B/A AVITA PHARMACY 1063	1860 WALT WHITMAN RD STE 700	MELVILLE	NY	11747	07/30/2021	08/05/2021	10/01/2021	08/05/2021
Contract Detail	CATHOLIC HEALTH SYSTEM INFUSION PHARMACY	D/B/A CATHOLIC HEALTH INFUSION PHARMACY	6350 TRANSIT RD	DEPEW	NY	14043	07/30/2021	08/05/2021	10/01/2021	08/05/2021
Contract Detail	CATHOLIC HEALTH SYSTEM INFUSION PHARMACY	CATHOLIC HEALTH RX AT SISTERS HOSPITAL	2157 MAIN ST	BUFFALO	NY	14214-2648	09/17/2021	10/01/2021	10/01/2021	10/01/2021

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH330078AA	Child	DSH	Sisters of Charity Hospital	Sisters Central Park Diagnostic Center	34 Benwood Avenue	Buffalo	NY	Terminated
DSH330078AB	Child	DSH	Sisters of Charity Hospital	Sisters Hospital Star Program	3730 Sheridan Drive	Amherst	NY	Terminated
DSH330078AC	Child	DSH	Sisters of Charity Hospital	Sisters Ambulatory Surgery Center	45 Spindrift Drive	Williamsville	NY	Terminated
DSH330078AD	Child	DSH	Sisters of Charity Hospital	Rochestrer Pathways	79 Howell Street	Rochester	NY	Terminated
DSH330078AE	Child	DSH	SISTERS OF CHARITY HOSPITAL	CHS Partners in Rehab	6199 Transit Road	Depew	NY	Terminated
DSH330078AF	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Catherine Laboure Health Care Center - Medical Adult Day Care	2157 Main Street	Buffalo	NY	Active
DSH330078AG	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Catherine’s Laboure Health Care Center - Skilled Nursing & Outpatient Drugs	2157 Main Street	Buffalo	NY	Terminated
DSH330078AH	Child	DSH	SISTERS OF CHARITY HOSPITAL	Piver Center - Outpatient Clinic	2121 Main Street	Buffalo	NY	Active
DSH330078AJ	Child	DSH	SISTERS OF CHARITY HOSPITAL	Piver Center - Oncology - Oncology	2121 Main Street	Buffalo	NY	Active
DSH330078AK	Child	DSH	SISTERS OF CHARITY HOSPITAL	PACE Health Center Lackawanna - Primary Care	55 Melroy Avenue	Lackawanna	NY	Active
DSH330078AL	Child	DSH	SISTERS OF CHARITY HOSPITAL	SISTERS HEALTH CENTER AMHERST - Alcohol and Chemical Dependency Pathways	210 JOHN GLENN DR	AMHERST	NY	Active
DSH330078AM	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Depew - Infusion	6199 Transit Road	Depew	NY	Active
DSH330078AN	Child	DSH	SISTERS OF CHARITY HOSPITAL	MERCY COMPREHENSIVE CARE CENTER - Mercy Comprehensive Care Ctr - Adult	397 LOUISIANA ST	BUFFALO	NY	Active
DSH330078AP	Child	DSH	SISTERS OF CHARITY HOSPITAL	KEN-TON FAMILY CARE CENTER - Ken-Ton - Adult	2625 Delaware Ave	Buffalo	NY	Active
DSH330078AQ	Child	DSH	SISTERS OF CHARITY HOSPITAL	OLV FAMILY CARE CENTER - OLV Family Care	227 RIDGE RD	LACKAWANNA	NY	Terminated
DSH330078AR	Child	DSH	SISTERS OF CHARITY HOSPITAL	Villa Maria Campus PACE Clinic - PACE-VM Clinic	600 Doat St	Cheektowaga	NY	Active
DSH330078AS	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Caritas - Sisters Health Center Caritas - Adult	2625 Harlem Road	Cheektowaga	NY	Active
DSH330078AT	Child	DSH	SISTERS OF CHARITY HOSPITAL	Mercy Neurology Center - Neurology	515 Abbott Road	Buffalo	NY	Active
DSH330078AU	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center D'Youville - Primary Care	301 Connecticut Street	Buffalo	NY	Active
DSH330078AV	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - GI ENDOSCOPY - GI Endoscopy	2605 Harlem Rd	Cheektowaga	NY	Active
DSH330078AW	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - ASU PRE PROC - Ambulatory Surgery	2605 Harlem Rd	Cheektowaga	NY	Active
DSH330078AX	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - PULMONARY FUNCT - Respiratory Therapy	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078AZ	Child	DSH	SISTERS OF CHARITY HOSPITAL	MERCY COMPREHENSIVE CARE CENTER - ORTHOPEDICS - Orthopedics	397 Louisiana St	Buffalo	NY	Active
DSH330078C	Child	DSH	SISTERS OF CHARITY HOSPITAL	SAINT VINCENT HEALTH CENTER	1500 Broadway Street	BUFFALO	NY	Active
DSH330078CB	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Caritas - INFUSION SERVICES - Infusion Services	2625 Harlem Road	Cheektowaga	NY	Terminated
DSH330078CC	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus -PACU RECOVERY - PACU	2605 Harlem Rd	Cheektowaga	NY	Active
DSH330078CD	Child	DSH	SISTERS OF CHARITY HOSPITAL	SISTERS HEALTH CENTER AMHERST - INF DIS - Infectious Disease	210 John Glenn Drive	Amherst	NY	Active
DSH330078CE	Child	DSH	SISTERS OF CHARITY HOSPITAL	SAINT VINCENT HEALTH CENTER - STAR - Addiction Management	1500 Broadway St	Buffalo	NY	Active
DSH330078CF	Child	DSH	SISTERS OF CHARITY HOSPITAL	KEN-TON FAMILY CARE CENTER - Ken-Ton - PEDS - Pediatrics	2625 Delaware Ave. Suite 124	Buffalo	NY	Active
DSH330078CG	Child	DSH	SISTERS OF CHARITY HOSPITAL	SISTERS HEALTH CENTER AMHERST - Prim CR - Primary Care	210 John Glenn Drive	Amherst	NY	Active
DSH330078CH	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Caritas - GI - GI	2625 Harlem Road	Cheektowaga	NY	Active
DSH330078CJ	Child	DSH	SISTERS OF CHARITY HOSPITAL	KEN-TON FAMILY CARE CENTER - Ken-Ton -OBGYN - OBGYN	2625 Delaware Ave	Buffalo	NY	Active
DSH330078CK	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Caritas - ENDO - Endocrinology	2625 Harlem Road	Cheektowaga	NY	Active
DSH330078CL	Child	DSH	SISTERS OF CHARITY HOSPITAL	MERCY COMPREHENSIVE CARE CENTER - PEDIATRICS - Pediatrics	397 Louisiana St	Buffalo	NY	Active
DSH330078CM	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center D'Youville - BARIATRIC - Bariatric	301 Connecticut Street	Buffalo	NY	Active
DSH330078CN	Child	DSH	SISTERS OF CHARITY HOSPITAL	MERCY COMPREHENSIVE CARE CENTER - OBGYN - OBGYN	397 Louisiana St	Buffalo	NY	Active
DSH330078CP	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Caritas - INF DIS - Infectious Disease	2625 Harlem Road	Cheektowaga	NY	Active
DSH330078CQ	Child	DSH	SISTERS OF CHARITY HOSPITAL	Pathways Methadone - Health Center - Pathways Opioid Treatment Center	158 Holden Street	Buffalo	NY	Active
DSH330078CR	Child	DSH	SISTERS OF CHARITY HOSPITAL	Sisters Health Center Depew - Dr Soh - Oncology Clinic	6199 Transit Road	Depew	NY	Active
DSH330078J	Child	DSH	SISTERS OF CHARITY HOSPITAL	Pathways Methadone	158 Holden Street	Buffalo	NY	Active
DSH330078K	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Emergency Room	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078L	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus Clinic - Advanced Wound Care	2625 Harlem Road	Cheektowaga	NY	Active
DSH330078M	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Ultrasound	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078N	Child	DSH	Sisters of Charity Hospital	St. Joseph Campus - EEG	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078P	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - EKG, Stress Test, Echocardiography	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078Q	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Physical Therapy	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078R	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Respiratory Therapy	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078S	Child	DSH	Sisters of Charity Hospital	St. Joseph Campus - Occupational Therapy	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078T	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Laboratory	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078U	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - CT Scan	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078V	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Radioisitope	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078W	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Radiology Diagnostic	2605 Harlem Road	Cheektowaga	NY	Terminated
DSH330078X	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus - Anesthesia	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078Y	Child	DSH	SISTERS OF CHARITY HOSPITAL	St. Joseph Campus-Operating Room	2605 Harlem Road	Cheektowaga	NY	Active
DSH330078Z	Child	DSH	Sisters of Charity Hospital	St. Joseph Campus - Speech Therapy	2605 Harlem Road	Cheektowaga	NY	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Group Change Request	Greer, Tristan Diane 340B Program Business Manager Catholic Health System 7169232920	Holody, Selena Analyst, 340B Program Catholic Health System 7162706981	1/10/2025 10:13 AM
Addresses	Billing Address	Insert	Recertification		Sisters of Charity Hospital C/O Catholic Health 144 Genesee Street 4th Floor Buffalo, NY 14203	9/3/2024 7:48 AM
Addresses	Shipping Address	Insert	Recertification		SISTERS OF CHARITY HOSPITAL 2157 Main Street Buffalo, NY 14214	9/3/2024 7:48 AM
Medicaid Billing	NPI: Number	Delete	Recertification	1043455199 (NY)		9/3/2024 7:48 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1790727543	9/3/2024 7:48 AM
Medicaid Billing	NPI: State	Insert	Recertification		NY	9/3/2024 7:48 AM
Details	Last Recertification Date	Update	Recertification	8/29/2023 2:38:30 PM	9/3/2024 7:48:54 AM	9/3/2024 7:48 AM
Details	Entity Subname	Update	Change Request	MERCY COMPREHENSIVE CARE CENTER - Mercy Comprehensive Care Ctr	MERCY COMPREHENSIVE CARE CENTER - Mercy Comprehensive Care Ctr - Adult	1/8/2024 7:11 AM
Details	Last Recertification Date	Update	Recertification	9/7/2022 12:06:31 PM	8/29/2023 2:38:30 PM	8/29/2023 2:38 PM
Details	Last Recertification Date	Update	Recertification	8/16/2021 1:44:28 PM	9/7/2022 12:06:31 PM	9/7/2022 12:06 PM
Details	Last Recertification Date	Update	Recertification		8/16/2021 1:44:28 PM	8/16/2021 1:44 PM
Details	State	Update		Approved	Active	4/1/2021 12:01 AM
Contacts	Signed By	Insert	New Registration		Osborne, Michael Vice President, Finance Catholic Health System 7168282011	3/3/2021 5:05 PM
Details	340B ID	Update	New Registration		DSH330078AN	3/3/2021 5:05 PM
Details	Entity Subname	Update	New Registration	MERCY COMPREHENSIVE CARE CENTER	MERCY COMPREHENSIVE CARE CENTER - Mercy Comprehensive Care Ctr	3/3/2021 5:05 PM
Dates	Participating Approval Date	Update	New Registration		3/3/2021 5:05:02 PM	3/3/2021 5:05 PM
Details	State	Update	New Registration	Pending	Approved	3/3/2021 5:05 PM
Dates	Signed By Date	Update	New Registration		2/9/2021 2:10:59 PM	3/3/2021 5:05 PM
Dates	Start Date	Update	New Registration		4/1/2021 12:00:00 AM	3/3/2021 5:05 PM
Addresses	Main Address	Insert	New Registration		397 LOUISIANA ST BUFFALO, NY 14204-2275	1/6/2021 12:48 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/6/2021 12:48 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		03075789	1/6/2021 12:48 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		NY	1/6/2021 12:48 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1043455199	1/6/2021 12:48 PM
Medicaid Billing	NPI: State	Insert	New Registration		NY	1/6/2021 12:48 PM
Contacts	Authorizing Official	Insert	New Registration		Osborne, Michael Vice President, Finance Catholic Health System 7168282011	1/6/2021 12:48 PM
Contacts	Primary Contact	Insert	New Registration		Greer, Tristan Diane 340B Program Business Manager Catholic Health System 7169232920	1/6/2021 12:48 PM
Details	Assistance Received From Date	Insert	New Registration			1/6/2021 12:48 PM
Details	Assistance Received To Date	Insert	New Registration			1/6/2021 12:48 PM
Details	Last Recertification Date	Insert	New Registration			1/6/2021 12:48 PM
Details	Grant Number	Insert	New Registration			1/6/2021 12:48 PM
Details	340B ID	Insert	New Registration			1/6/2021 12:48 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/6/2021 12:48 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/6/2021 12:48 PM
Details	Medicare Provider Number	Insert	New Registration		330078	1/6/2021 12:48 PM
Details	Entity Name	Insert	New Registration		SISTERS OF CHARITY HOSPITAL	1/6/2021 12:48 PM
Details	NOFO Number	Insert	New Registration			1/6/2021 12:48 PM
Details	Program Code	Insert	New Registration		DSH	1/6/2021 12:48 PM
Details	Entity Subname	Insert	New Registration		MERCY COMPREHENSIVE CARE CENTER	1/6/2021 12:48 PM
Dates	Participating Approval Date	Insert	New Registration			1/6/2021 12:48 PM
Details	State	Insert	New Registration		Pending	1/6/2021 12:48 PM
Dates	Registration Date	Insert	New Registration		1/6/2021 12:48:50 PM	1/6/2021 12:48 PM
Dates	Signed By Date	Insert	New Registration			1/6/2021 12:48 PM
Dates	Start Date	Insert	New Registration			1/6/2021 12:48 PM
Terminations	Termination Comments	Insert	New Registration			1/6/2021 12:48 PM
Terminations	Termination Date	Insert	New Registration			1/6/2021 12:48 PM
Terminations	Termination Effective Date	Insert	New Registration			1/6/2021 12:48 PM
Terminations	Termination Reason	Insert	New Registration			1/6/2021 12:48 PM