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DSH330238E NICHOLAS H. NOYES MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
NICHOLAS H. NOYES MEMORIAL HOSPITAL
Subdivision Name
Noyes Outpatient Mental Health Service
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330238E
Medicare Provider Number
330238
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/25/2017
Last Recertification Date
8/14/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Nicholas H. Noyes Memorial Hospital
Mark F Prunoske, SVP/CFO
(585) 335-4306
Primary Contact
UR Medicine
Katy Lees, Director, 340B Policy and Business Strategy
(585) 703-5169 Ext: 5855964002
Addresses
Street Address
9221 Robert Hart Drive
Dansville, NY 14437
Billing Address
Noyes Memorial Hospital
111 Clara Barton Street
Dansville, NY 14437
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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