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DSH330238Q NICHOLAS H. NOYES MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
NICHOLAS H. NOYES MEMORIAL HOSPITAL
Subdivision Name
UR Medicine/Noyes Health Dialysis Center - UR Medicine/Noyes Health Dialysis Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330238Q
Medicare Provider Number
330238
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/6/2019
Last Recertification Date
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Nicholas H. Noyes Memorial Hospital
Mark F Prunoske, SVP/CFO
(585) 335-4306
Primary Contact
UR Medicine
Katy Lees, Director, 340B Policy and Business Strategy
(585) 703-5169 Ext: 5855964002
Addresses
Street Address
11 Murray Hill Drive
Suite E003
Mount Morris, NY 14510-1153
Billing Address
Noyes Memorial Hospital
111 Clara Barton Street
Dansville, NY 14437
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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