340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH330203 CROUSE HOSPITAL (Active)
Print
Main Details
Name
CROUSE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330203
Medicare Provider Number
330203
Additional Details
Current Program Status
Active
Registration Date
9/8/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/13/2023
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Crouse Hospital
Kevin Randall, Chief Financial Officer
(315) 470-7589
Primary Contact
Crouse Health
Dwayne Cleveland, Manager of 340B
(315) 470-3402
Addresses
Street Address
736 IRVING AVE
SYRACUSE, NY 13210
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Participated starting 7/1/2008, terminated 1/1/2014. Reinstated 10/1/2023.
09/13/2023
4/17/09 REMOVED MEDICAID# (WAS 3360372)
06/03/2008
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session