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SCH330079-00 Adirondack Medical Center (Terminated)
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Main Details
Name
Adirondack Medical Center
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH330079-00
Medicare Provider Number
330079
Additional Details
Current Program Status
Terminated
Registration Date
10/10/2012
Participating Start Date
10/1/2015
Participating Approval Date
10/19/2012
Last Recertification Date
8/30/2023
Termination Date
Termination Reason
7/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Adirondack Medical Center
William Breckinrdge Chapin, Chief Financial Officer
(518) 897-2347
Primary Contact
Adirondack Medical Center
Jake Perry Singer, Director of Pharmacy
(518) 897-2319
Addresses
Street Address
2233 State Route 86
Saranac Lake, NY 12983
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/14/15 participating 10/27/12 thru 9/30/14, not participating 10/1/14 thru 9/30/15 due to DSH% falling below statutory minimum, reinstated effective 10/1/15 based on on-line registration submitted in July 2015;
08/14/2015
11/2/2012 – Participation start date changed from 1/1/2013 to 10/27/2012 to reflect post-Sandy public health emergency determination for the State of New York [T.Lew]
11/05/2012
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