340B Drug Pricing Program Database
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DSH330047A ST. MARYS HEALTHCARE (Active)
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Main Details
Name
ST. MARYS HEALTHCARE
Subdivision Name
Health Center at Johnstown
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330047A
Medicare Provider Number
330047
Outpatient Facility Provider Number
330047
Additional Details
Current Program Status
Active
Registration Date
2/28/2012
Participating Start Date
3/7/2012
Participating Approval Date
3/7/2012
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
700 South Perry Street
Johnstown, NY 12095
Billing Address
St. Mary's Healthcare
427 Guy Park Avenue
Amsterdam, NY 12010
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/29/12 sent intial email
02/28/2012
May 2025
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