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DSH330219E ERIE COUNTY MEDICAL CENTER (Active)
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Main Details
Name
ERIE COUNTY MEDICAL CENTER
Subdivision Name
ERIE COUNTY MEDICAL CENTER CORPORAT - Downtown Substance Abuse Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330219E
Medicare Provider Number
330219
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/23/2019
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Erie County Medical Center
Jonathan Thomas Swiatkowski, Chief Financial Officer
(716) 898-6291
Primary Contact
Erie County Medical Center
Mechelle Annette DiMaria, Pharmacy Business Coordinator
(716) 898-5520
Addresses
Street Address
1285 MAIN ST
BUFFALO, NY 14209-1911
Billing Address
Erie County Medical Center
462 Grider Street
Buffalo, NY 14215
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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