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RRC330125-00 ROCHESTER GENERAL HOSPITAL (Terminated)
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Main Details
Name
ROCHESTER GENERAL HOSPITAL
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC330125-00
Medicare Provider Number
330125
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/15/2019
Last Recertification Date
Termination Date
Termination Reason
10/1/2019
Change of covered entity type
Contacts
Authorizing Official
Rochester Regional Health
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941
Primary Contact
Rochester Regional
Karen M Kinter, Vice President of Specialty Revenue Programs
(585) 368-3537
Addresses
Street Address
1425 PORTLAND AVENUE
ROCHESTER, NY 14617
Billing Address
Rochester General Hospital
1425 Portland Avenue
Rochester, NY 14621
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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