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DSH330136CU MARY IMOGENE BASSETT HOSPITAL (Approved)
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Main Details
Name
MARY IMOGENE BASSETT HOSPITAL
Subdivision Name
BASSETT HEALTHCARE Anticoagulation Management Service at FoxCare - Anticoagulation Management Service at FoxCare
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330136CU
Medicare Provider Number
330136
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/14/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/1/2025
Last Recertification Date
Contacts
Authorizing Official
Bassett Healthcare Network
James Vielkind, Vice President Finance
(315) 823-5281
Primary Contact
Bassett Healthcare - Cooperstown, NY
Kim Metcalf, Chief Pharmacy Officer
(860) 975-5636
Addresses
Street Address
1 FoxCare Drive
Oneonta, NY 13820
Billing Address
Mary Imogene Bassett Hospital
1 Atwell Road
Cooperstown, NY 13326
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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