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DSH330096E JONES MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
JONES MEMORIAL HOSPITAL
Subdivision Name
Midwife
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330096E
Medicare Provider Number
330096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/28/2017
Last Recertification Date
9/8/2021
Termination Date
Termination Reason
10/1/2022
Other
Contacts
Authorizing Official
The Memorial Hospital of William F. and Gertrude F. Jones, Inc.
James Helms, Chief Executive Officer
(585) 596-4002
Primary Contact
UR Medicine
Katy Lees, Director, 340B Policy and Business Strategy
(585) 703-5169 Ext: 5855964002
Addresses
Street Address
127 N MAIN ST
WELLSVILLE, NY 14895-1149
Billing Address
Jones Memorial Hospital
191 North Main Street
Wellsville, NY 14895
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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