340B Drug Pricing Program Database
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DSH330153AK Ellis Hospital (Active)
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Main Details
Name
Ellis Hospital
Subdivision Name
Ellis - Adolescent Mental Health
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330153AK
Medicare Provider Number
330153
Outpatient Facility Provider Number
330153
Additional Details
Current Program Status
Active
Registration Date
7/11/2013
Participating Start Date
10/1/2013
Participating Approval Date
7/17/2013
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Ellis
Marc Mesick, CFO & VP of Finance
(518) 243-4144
Primary Contact
Ellis Hospital
Monica Quinde, Pharmacy 340B Program Manager
(518) 243-1824
Addresses
Street Address
1023 State Street
Schenectady, NY 12307
Billing Address
Ellis Hospital
600 McClellan St
Schenectady, NY 12304
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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