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SCH330223-11 MASSENA HOSPITAL, INC. (Terminated)
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Main Details
Name
MASSENA HOSPITAL, INC.
Subdivision Name
MMH LEVINE CLINIC
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH330223-11
Medicare Provider Number
330223
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/14/2017
Last Recertification Date
9/13/2021
Termination Date
Termination Reason
10/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Rochester Regional Health
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941
Primary Contact
Rochester Regional
Karen M Kinter, Vice President of Specialty Revenue Programs
(585) 368-3537
Addresses
Street Address
one hospital drive
MASSENA, NY 13662
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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