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DSH330188 Mount St. Mary's Hospital and Health Center (Active)
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Main Details
Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330188
Medicare Provider Number
330188
Additional Details
Current Program Status
Active
Registration Date
12/9/2010
Participating Start Date
1/1/2014
Participating Approval Date
12/14/2010
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Catholic Health System
Michael Osborne, Vice President, Finance
(716) 828-2011
Primary Contact
Catholic Health System
Selena Holody, Analyst, 340B Program
(716) 270-6981
Addresses
Street Address
5300 MILITARY ROAD
LEWISTON, NY 14092
Billing Address
MOUNT ST.MARY'S HOSPITAL AND HEALTH CENTER C/O CATHOLIC HEALTH
144 GENESEE STREET
4TH FLOOR
BUFFALO, NY 14203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/21/13 enrolled 1/1/11 thru 6/30/12, not enrolled 7/1/12 thru 12/31/13 (terminated at request of covered entity), reinstated based on on-line registration submitted in Oct. 2013; 12/9/2010- DOC RECD TO CONFIRM ELIG DSH ADJ%
11/21/2013
12/9/2010- DOC RECD TO CONFIRM ELIG DSH ADJ%
12/14/2010
April 2025
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