340B Drug Pricing Program Database
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DSH330047 ST. MARYS HEALTHCARE (Active)
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Main Details
Name
ST. MARYS HEALTHCARE
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330047
Medicare Provider Number
330047
Additional Details
Current Program Status
Active
Registration Date
9/23/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/23/2009
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
St. Mary's Healthcare
Keith Waters, Vice President of Finance/CFO
(518) 770-7583
Primary Contact
St. Mary's Healthcare
Tami Wessel, 340B Program Lead
(518) 256-1163
Addresses
Street Address
427 GUY PARK AVENUE
AMSTERDAM, NY 12010
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/1/09 REINSTATED ORIG PART FROM 10/19/05 TO 3/31/07 NOT ELIG FROM 4/1/2007 TO 9/30/2009; 8/4/2009 DOC RECD TO CONFIRM ELIG DSH ADJ%;
09/23/2009
May 2025
May 2025
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