340B Drug Pricing Program Database
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DSH330044 MVHS, Inc. DBA: Wynn Hospital (Active)
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Main Details
Name
MVHS, Inc. DBA: Wynn Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330044
Medicare Provider Number
330044
Additional Details
Current Program Status
Active
Registration Date
4/15/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/25/2014
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
MVHS Inc, DBA Wynn Hospital
Louis Aiello, Sr. VP Finance/ CFO
(315) 917-8213
Primary Contact
MVHS, Inc. DBA: Wynn Hospital
James Humphrey, AVP Finance/ Controller
(315) 801-4326
Addresses
Street Address
111 Hospital Drive
Utica, NY 13502
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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WALGREEN EASTERN CO., INC., WALGREENS #17097, 1616 BLACK RIVER BLVD N, ROME NY was terminated in error on 2/10/2020. This pharmacy has been eligible since 7/1/2019 and continued to be eligible from 2/10/2020 through 3/16/2020.
04/14/2020
April 2025
April 2025
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