340B Drug Pricing Program Database
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DSH330047H ST. MARYS HEALTHCARE (Active)
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Main Details
Name
ST. MARYS HEALTHCARE
Subdivision Name
Health Center at Canajoharie
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330047H
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
48 Erie Boulevard
Canajoharie, NY 13317
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
April 2025
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