340B Drug Pricing Program Database
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DSH330005AY KALEIDA HEALTH (Active)
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Main Details
Name
KALEIDA HEALTH
Subdivision Name
MAPLE WEST PLAZA / OCCUPATIONAL THERAPY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330005AY
Medicare Provider Number
330005
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/4/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/10/2017
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Kaleida Health
Chisholm P Hugh, EVP Chief Financial Officer
(716) 859-8836
Primary Contact
Kaleida Health
Wendy Ann DellaNeve, Manager 340B Program
(716) 859-8012
Addresses
Street Address
705 MAPLE ROAD
WILLIAMSVILLE, NY 14221
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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