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DSH330065C NIAGARA FALLS MEMORIAL MEDICAL CENTER (Active)
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Main Details
Name
NIAGARA FALLS MEMORIAL MEDICAL CENTER
Subdivision Name
PORTER ROAD LABORATORY DRAW STATION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330065C
Medicare Provider Number
330065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/13/2007
Participating Start Date
7/1/2007
Participating Approval Date
6/14/2007
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Niagara Falls Memorial Medical Center
Matthew DuBois, VP & CFO
(716) 278-4399
Primary Contact
Niagara Falls Memorial Medical Center
Julie Czyzewski, 340B Coordinator
(716) 278-4450
Addresses
Street Address
7751 PORTER ROAD
NIAGARA FALLS, NY 14304
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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