340B Drug Pricing Program Database
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RRC330094-20 Columbia Memorial Hospital (Terminated)
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Main Details
Name
Columbia Memorial Hospital
Subdivision Name
Coxsackie Medical Care
Type
Rural Referral Center
Rural
Yes
340B ID
RRC330094-20
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
9/14/2022
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
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
9 Law Street
West Coxsackie, NY 12192
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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