340B Drug Pricing Program Database
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DSH330065H NIAGARA FALLS MEMORIAL MEDICAL CENTER (Terminated)
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Main Details
Name
NIAGARA FALLS MEMORIAL MEDICAL CENTER
Subdivision Name
Niagara Metabolic and Bariatric Services - Metabolic and Bariatric Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330065H
Medicare Provider Number
330065
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/30/2017
Last Recertification Date
8/16/2023
Termination Date
Termination Reason
4/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Niagara Falls Memorial Medical Center
Richard G Braun Jr, EVP Chief Financial Officer
(716) 908-9333
Primary Contact
Niagara Falls Memorial Medical Center
Julie Czyzewski, 340B Coordinator
(716) 278-4450
Addresses
Street Address
620 10th Street
Suite 704
Niagara Falls, NY 14301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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