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DSH330188J Mount St. Mary's Hospital and Health Center (Active)
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Main Details
Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
Mount St. Mary's Surgical Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330188J
Medicare Provider Number
330188
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/16/2016
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Catholic Health System
Michael Osborne, Vice President, Finance
(716) 828-2011
Primary Contact
Catholic Health System
Selena Holody, Analyst, 340B Program
(716) 270-6981
Addresses
Street Address
5320 Military Road
Suite 107
Lewiston, NY 14092-1997
Billing Address
Mount St. Mary's Hospital and Health Center c/o Catholic Health
144 Genesee Street
4th Floor
Buffalo, NY 14203-1997
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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