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RRC330094-31 Columbia Memorial Hospital (Terminated)
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Main Details
Name
Columbia Memorial Hospital
Subdivision Name
Columbia Memorial Endocrinology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC330094-31
Medicare Provider Number
330094
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/12/2014
Last Recertification Date
8/15/2016
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
Columbia Memorial Hospital
Bryan T. Mahoney, Chief Financial Officer
(518) 697-3230
Primary Contact
Columbia Memorial Hospital
Kelly Barrett, Manager of Financial Planning
(518) 828-8121
Addresses
Street Address
23 Fish & Game Rd
Hudson, NY 12534
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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