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DSH330096G JONES MEMORIAL HOSPITAL (Active)
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Main Details
Name
JONES MEMORIAL HOSPITAL
Subdivision Name
Family Practice
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330096G
Medicare Provider Number
330096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/14/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/28/2017
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Jones Memorial Hospital
Boyd Chappell, Vice President of Finance / Chief Financial Officer
(585) 596-4002
Primary Contact
UR Medicine
Katy Lees, Director, 340B Policy and Business Strategy
(585) 703-5169 Ext: 5855964002
Addresses
Street Address
120 FIRST ST
BOLIVAR, NY 14715
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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