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DSH330033X CHENANGO MEMORIAL HOSPITAL (Active)
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Main Details
Name
CHENANGO MEMORIAL HOSPITAL
Subdivision Name
UHS CMH-GASTROENTEROLOGY - GASTROENTEROLOGY
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330033X
Medicare Provider Number
330033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/21/2024
Last Recertification Date
Contacts
Authorizing Official
Chenango Memorial Hospital, Inc.
Desiree A Axley, Vice President Finance & CFO
(607) 373-6912
Primary Contact
United Health Services Hospitals, Inc
Ryan C. Decaro, Pharmacy Business Manager
(607) 763-1838
Addresses
Street Address
4 Newton Ave
Norwich, NY 13815
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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