340B Drug Pricing Program Database
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DSH330044A MVHS, Inc. DBA: Wynn Hospital (Active)
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Main Details
Name
MVHS, Inc. DBA: Wynn Hospital
Subdivision Name
Imaging Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330044A
Medicare Provider Number
330044
Outpatient Facility Provider Number
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.
Matthew Archer, 340B Business Manager
(315) 525-7947
Addresses
Street Address
106 Business Park Drive
Utica, NY 13502
Billing Address
Faxton St. Luke's Healthcare
1676 Sunset Ave.
Utica, NY 13502
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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