340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH330047W ST. MARYS HEALTHCARE (Terminated)
Print
Main Details
Name
ST. MARYS HEALTHCARE
Subdivision Name
Broadalbin Health Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330047W
Medicare Provider Number
330047
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/1/2016
Last Recertification Date
Termination Date
Termination Reason
7/1/2017
Loss of qualifying grant/support
Contacts
Authorizing Official
St. Mary's Healthcare
Rick Henze, Vice President of Finance/CFO
(518) 841-7435
Primary Contact
St. Mary's Healthcare
Keith Waters, Sr. Director Of Finance
(518) 770-7583
Addresses
Street Address
3768 State Highway 30
Broadalbin, NY 12025
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session