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CAH331316-00 COMMUNITY MEMORIAL HOSPITAL INC. (Active)
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Main Details
Name
COMMUNITY MEMORIAL HOSPITAL INC.
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH331316-00
Medicare Provider Number
331316
Additional Details
Current Program Status
Active
Registration Date
1/20/2015
Participating Start Date
4/1/2015
Participating Approval Date
1/22/2015
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Community Memorial Hospital
Carrie Bova, Senior Director of Business Devolpment
(315) 824-6560
Primary Contact
Community Memorial Hospital
Christopher Todd, Director of Pharmacy
(315) 824-6587
Addresses
Street Address
150 BROAD ST
HAMILTON, NY 13346
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/22/15 Approved for off-cycle start due to extenuating circumstances.
01/22/2015
April 2025
April 2025
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