340B Drug Pricing Program Database
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DSH330276W NATHAN LITTAUER HOSPITAL (Terminated)
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Main Details
Name
NATHAN LITTAUER HOSPITAL
Subdivision Name
Gloversville Primary Care Center / Gastroenterology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330276W
Medicare Provider Number
330276
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/7/2019
Last Recertification Date
8/17/2023
Termination Date
Termination Reason
1/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Nathan Littauer Hospital
Michael Ostrander, Vice President-Finance & CFO
(518) 773-5480
Primary Contact
Nathan Littauer Hospital
Brenda Hammons, Pharmacy 340B Coordinator
(518) 773-5582
Addresses
Street Address
99 East State Street
Gloversville, NY 12078
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 10/1/2016; Termination date 7/1/2017; Reinstated 1/1/20.
10/07/2019
May 2025
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