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DSH330033C CHENANGO MEMORIAL HOSPITAL (Active)
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Main Details
Name
CHENANGO MEMORIAL HOSPITAL
Subdivision Name
UHS PRIM CARE OXFORD-FAMILY PRACTICE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330033C
Medicare Provider Number
330033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/9/2010
Participating Start Date
10/1/2016
Participating Approval Date
3/11/2010
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Chenango Memorial Hospital, Inc.
Desiree A Axley, Vice President Finance & CFO
(607) 373-6912
Primary Contact
United Health Services Hospitals, Inc
Ryan C. Decaro, Pharmacy Business Manager
(607) 763-1838
Addresses
Street Address
21N CANAL ST
OXFORD, NY 13830-3435
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/8/16 Participated starting 4/1/2010 until terminated 10/1/2013, reinstated effective 10/1/2016
09/08/2016
3/9/10 DOC. RECD. TO CONFIRM DSH ADJ. %
03/26/2010
May 2025
May 2025
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