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DSH330090E ARNOT OGDEN MEDICAL CENTER (Terminated)
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Main Details
Name
ARNOT OGDEN MEDICAL CENTER
Subdivision Name
Schuyler Dialysis
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330090E
Medicare Provider Number
330090
Outpatient Facility Provider Number
333557
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2011
Participating Start Date
10/27/2012
Participating Approval Date
11/29/2012
Last Recertification Date
9/1/2015
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Arnot Health
Mark Dworsky, Vice President of Clinical Services
(607) 737-4152
Primary Contact
Arnot Helath
BILL BACON, DIRECTOR OF PHARMACY
(607) 737-4311
Addresses
Street Address
220 Steuben Street
Montour Falls, NY 14865
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/29/12 participating 12/15/11 thru 6/30/12, not participating 7/1/12 thru 10/26/12, re-instated based on new registration, early start date due to post-Sandy public health emergency determination for the State of New York; 6/28/12 Terminated at the request of the covered entity, effective 7/1/12;12/15/11 START DATE IS IMMEDIATE DUE TO PHE IN NYS
11/29/2012
6/28/12 Terminated at the request of the covered entity, effective 7/1/12; 12/15/11 START DATE IS IMMEDIATE DUE TO PHE IN NYS
06/28/2012
12/15/11 START DATE IS IMMEDIATE DUE TO PHE IN NYS
12/15/2011
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