340B Drug Pricing Program Database
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DSH330261B PHELPS MEMORIAL HOSPITAL CENTER (Active)
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Main Details
Name
PHELPS MEMORIAL HOSPITAL CENTER
Subdivision Name
Phelps Hospital SurgiCenter
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330261B
Medicare Provider Number
330261
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/25/2016
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Northwell Health
Michele L Cusack, Executive Vice President
(516) 321-6058
Primary Contact
Northwell
Onisis Stefas, VP of Pharmacy Operations
(516) 719-5720
Addresses
Street Address
755 North Broadway
3rd Floor
Sleepy Hollow, NY 10591
Billing Address
PHELPS MEMORIAL HOSPITAL CENTER
701 NORTH BROADWAY
Sleepy Hollow, NY 10591
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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