340B Drug Pricing Program Database
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RRC330103-00 Olean General Hospital (Terminated)
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Main Details
Name
Olean General Hospital
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC330103-00
Medicare Provider Number
330103
Additional Details
Current Program Status
Terminated
Registration Date
1/8/2014
Participating Start Date
4/1/2014
Participating Approval Date
2/27/2014
Last Recertification Date
8/23/2018
Termination Date
Termination Reason
10/1/2019
Change of covered entity type
Contacts
Authorizing Official
Bradford Regional Medical Center
Richard G. Braun Jr., SVP Finance and CFO
(716) 375-6190
Primary Contact
Olean General Hospital
Victoria Nosowicz, Pharmacy Informatics & 340B Manager
(716) 375-6268
Addresses
Street Address
515 Main Street
Olean, NY 14760
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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