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DSH330090J ARNOT OGDEN MEDICAL CENTER (Terminated)
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Main Details
Name
ARNOT OGDEN MEDICAL CENTER
Subdivision Name
ARNOT OGDEN MEDICAL CENTER - AOMC - HSB Third floor Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330090J
Medicare Provider Number
330090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/2/2019
Last Recertification Date
8/23/2021
Termination Date
Termination Reason
10/1/2022
Other
Contacts
Authorizing Official
Arnot Ogden Medical Center
Ronette Wiley, Senior Vice President and Chief Operating Officer
(607) 737-4486
Primary Contact
ArnotHealth
Nicole M Dilmore, System Director of Pharmacy
(607) 737-4245
Addresses
Street Address
200 MADISON AVE
STE 2B
ELMIRA, NY 14901-3219
Billing Address
Arnot Ogden Medical Center
600 Roe Avenue
Elmira, NY 14905
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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