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DSH330164 HIGHLAND HOSPITAL OF ROCHESTER (Terminated)
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Main Details
Name
HIGHLAND HOSPITAL OF ROCHESTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330164
Medicare Provider Number
330164
Additional Details
Current Program Status
Terminated
Registration Date
3/4/2008
Participating Start Date
5/13/2013
Participating Approval Date
5/13/2013
Last Recertification Date
8/17/2016
Termination Date
Termination Reason
4/1/2017
DSH percentage below statutory minimum
Contacts
Authorizing Official
Highland Hospital
Kevin Segerson, Director of Finance
(585) 341-6686
Primary Contact
UR Medicine
Katy Lees, Director, 340B Policy and Business Strategy
(585) 703-5169 Ext: 5855964002
Addresses
Street Address
1000 SOUTH AVENUE
ROCHESTER, NY 14620
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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5/13/13 re-instated based on new registration, participating 4/1/08 thru 3/31/11, not participating 4/1/11 thru 5/12/13; 10/6/09- DOC RECD TO CONFIRM ELIG DSH ADJ %
05/13/2013
10/6/09- DOC RECD TO CONFIRM ELIG DSH ADJ %
03/31/2011
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