340B Drug Pricing Program Database
FILLMORE AND FISHER PHARMACY
DSH330096 JONES MEMORIAL HOSPITAL - information as of 5/24/2025 1:12:19 AM
Covered Entity Details
Entity Name
JONES MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330096
Entity Address
191 North Main Street
WELLSVILLE, NY 14895-0072
Medicare Provider Number
330096
Participating Start Date
10/1/2017
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
FILLMORE AND FISHER PHARMACY
Pharmacy Address
POST OFFICE BOX 272
10560 ROUTE 19
FILLMORE, NY 14735
Pharmacy Comments
Contract Details
Approval Date
8/10/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Helms, Vice President of Finance
(585) 596-4002
Contract Pharmacy Representative
Brian Loucks, Pharmacist
(585) 567-2228
Signed By Date
8/10/2017
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