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DSH330188G Mount St. Mary's Hospital and Health Center (Active)
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Main Details
Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
Mount St. Mary's Primary Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330188G
Medicare Provider Number
330188
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/25/2013
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Catholic Health System
Michael Osborne, Vice President, Finance
(716) 828-2011
Primary Contact
Catholic Health System
Selena Holody, Analyst, 340B Program
(716) 270-6981
Addresses
Street Address
5290 Military Road
Suite 8 Lower
Lewiston, NY 14092-1997
Billing Address
Mount St. Mary's Hospital and Health Center c/o Catholic Health
144 Genesee Street
4th Floor
Buffalo, NY 14203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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