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DSH330078AG SISTERS OF CHARITY HOSPITAL (Terminated)
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Main Details
Name
SISTERS OF CHARITY HOSPITAL
Subdivision Name
St. Catherine’s Laboure Health Care Center - Skilled Nursing & Outpatient Drugs
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330078AG
Medicare Provider Number
330078
Outpatient Facility Provider Number
335419
Additional Details
Current Program Status
Terminated
Registration Date
10/2/2017
Participating Start Date
10/1/2017
Participating Approval Date
10/3/2017
Last Recertification Date
9/14/2020
Termination Date
Termination Reason
3/5/2021
Other
Contacts
Authorizing Official
Catholic Health System
Michael Osborne, Vice President, Finance
(716) 828-2011
Primary Contact
Catholic Health System
Tristan Diane Greer, 340B Program Business Manager
(716) 923-2920
Addresses
Street Address
2157 Main Street
Buffalo, NY 14214
Billing Address
Sisters of Charity Hospital C/O Catholic Health
144 Genesee Street
Buffalo, NY 14203
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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