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CAH331312-04 DELAWARE VALLEY HOSPITAL INC. (Active)
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Main Details
Name
DELAWARE VALLEY HOSPITAL INC.
Subdivision Name
UHS 123 STOCKTON AVE-OUTPATIENT PHYSICAL THERAPY
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH331312-04
Medicare Provider Number
331312
Outpatient Facility Provider Number
331312
Additional Details
Current Program Status
Active
Registration Date
11/16/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/17/2010
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Delaware Valley Hospital, Inc.
LuCinda M Rider, Chief Financial Officer
(607) 865-2190
Primary Contact
United Health Services Hospitals, Inc
Ryan C. Decaro, Pharmacy Business Manager
(607) 763-1838
Addresses
Street Address
123 Stockton Avenue
WALTON, NY 13856
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/31/12-Updated addr(was 123 STOCKTON AVE)
01/31/2012
May 2025
May 2025
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