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DSH330090Z ARNOT OGDEN MEDICAL CENTER (Active)
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Main Details
Name
ARNOT OGDEN MEDICAL CENTER
Subdivision Name
AOMC Dermatology - Dermatology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330090Z
Medicare Provider Number
330090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/1/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/27/2020
Last Recertification Date
8/19/2024
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 Suite 1D
Elmira, NY 14901
Billing Address
Arnot Ogden Medical Center
600 Roe Ave
Elmira, NY 14905
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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