340B Drug Pricing Program Database
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DSH330065E NIAGARA FALLS MEMORIAL MEDICAL CENTER (Active)
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Main Details
Name
NIAGARA FALLS MEMORIAL MEDICAL CENTER
Subdivision Name
Niagara Falls Primary Care Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330065E
Medicare Provider Number
330065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/31/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/19/2012
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Niagara Falls Memorial Medical Center
Matthew DuBois, VP & CFO
(716) 278-4399
Primary Contact
Niagara Falls Memorial Medical Center
Julie Czyzewski, 340B Coordinator
(716) 278-4450
Addresses
Street Address
533 Tenth St Suite 100C
Niagara Falls, NY 14301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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