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DSH330157 SAMARITAN MEDICAL CENTER (Active)
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Main Details
Name
SAMARITAN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330157
Medicare Provider Number
330157
Additional Details
Current Program Status
Active
Registration Date
7/10/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/16/2020
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Samaritan Medical Center
Maxine A Briggs, VP Of Fiscal Services/Chief Financial Officer
(315) 755-3605
Primary Contact
Samaritan Medical Center
Diane M Loftus, Director of Pharmacy
(315) 785-4248
Addresses
Street Address
830 WASHINGTON STREET
WATERTOWN, NY 13601
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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