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SCH330175-00 GUTHRIE CORTLAND MEDICAL CENTER (Active)
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Main Details
Name
GUTHRIE CORTLAND MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH330175-00
Medicare Provider Number
330175
Additional Details
Current Program Status
Active
Registration Date
8/7/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/5/2023
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
The Guthrie Clinic
Matthew David Denniston, VP, Pharmacy Services
(570) 887-6626
Primary Contact
Robert Packer Hospital
Heather Lee Lodge, Pharmacy Services Financial Analyst
(570) 887-4375
Addresses
Street Address
134 HOMER AVENUE
CORTLAND, NY 13045
Billing Address
The Guthrie Clinic
One Guthrie Square
Sayre, PA 18840
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 5/16/2013; Terminated 10/1/2021; Reinstated 10/1/2023.
09/01/2023
April 2025
April 2025
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