340B Drug Pricing Program Database
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DSH330224 HealthAlliance Hospital Marys Avenue Campus (Terminated)
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Main Details
Name
HealthAlliance Hospital Marys Avenue Campus
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330224
Medicare Provider Number
330224
Additional Details
Current Program Status
Terminated
Registration Date
4/5/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/14/2016
Last Recertification Date
9/14/2021
Termination Date
Termination Reason
10/1/2022
DSH percentage below statutory minimum
Contacts
Authorizing Official
HealthAlliance
Michael Doyle, Executive Director & CMO
(845) 334-3070
Primary Contact
HealthAlliance of the Hudson Valley
Michael Schaff, Director, Pharmacy Services
(845) 334-2784
Addresses
Street Address
396 Broadway
KINGSTON, NY 12401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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