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DSH330033W CHENANGO MEMORIAL HOSPITAL (Active)
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Main Details
Name
CHENANGO MEMORIAL HOSPITAL
Subdivision Name
UHS CMH-OBGYN
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330033W
Medicare Provider Number
330033
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/4/2020
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Chenango Memorial Hospital, Inc.
Desiree A Axley, Vice President Finance & CFO
(607) 373-6912
Primary Contact
United Health Services Hospitals, Inc
Ryan C. Decaro, Pharmacy Business Manager
(607) 763-1838
Addresses
Street Address
32 CONKEY AVE.
NORWICH, NY 13815
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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