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RRC330094-12 Columbia Memorial Hospital (Terminated)
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Main Details
Name
Columbia Memorial Hospital
Subdivision Name
Neurosurgery and Spine
Type
Rural Referral Center
Rural
Yes
340B ID
RRC330094-12
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
8/30/2021
Termination Date
Termination Reason
10/1/2022
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
71 Prospect Ave
Medical Office Building
Suite L40
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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