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DSH330229 Brooks-TLC Hospital System Inc. (Terminated)
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Main Details
Name
Brooks-TLC Hospital System Inc.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330229
Medicare Provider Number
330229
Additional Details
Current Program Status
Terminated
Registration Date
2/14/2018
Participating Start Date
2/27/2018
Participating Approval Date
2/27/2018
Last Recertification Date
8/29/2023
Termination Date
Termination Reason
4/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Brooks-TLC Hospital System, Inc.
Julie Darlene Morton, Chief Operating Officer and Chief Nursing Officer
(716) 363-3077
Primary Contact
Brooks Memorial Hospital
Christopher Kotowski, Director of Pharmacy Services
(716) 363-3089
Addresses
Street Address
529 CENTRAL AVE.
DUNKIRK, NY 14048
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2015, terminated 1/1/2018. Reinstated immediately effective 2/27/2018.
02/27/2018
May 2025
May 2025
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