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RRC330094-22 Columbia Memorial Hospital (Active)
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Main Details
Name
Columbia Memorial Hospital
Subdivision Name
Columbia Memorial Surgical Associates
Type
Rural Referral Center
Rural
Yes
340B ID
RRC330094-22
Medicare Provider Number
330094
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/12/2014
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Columbia Memorial Hospital
Bryan T. Mahoney, Chief Financial Officer
(518) 697-3230
Primary Contact
Albany Med Health System
Alan W Slowick, System Associate Director of Pharmacy - 340B
(518) 926-2527
Addresses
Street Address
67 Prospect Ave
Medical Office Building
Suite 190
Hudson, NY 12534
Billing Address
Columbia Memorial Hospital
P.O. Box 2000
Hudson, NY 12534
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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