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DSH330238N NICHOLAS H. NOYES MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
NICHOLAS H. NOYES MEMORIAL HOSPITAL
Subdivision Name
NICHOLAS H NOYES MEMORIAL HOSPITAL / Anesthesia Service
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330238N
Medicare Provider Number
330238
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/25/2017
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
50 E SOUTH ST
GENESEO, NY 14454-1300
Billing Address
Nicholas Noyes 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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