340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH330157A SAMARITAN MEDICAL CENTER (Terminated)
Print
Main Details
Name
SAMARITAN MEDICAL CENTER
Subdivision Name
SAMARITAN MEDICAL CENTER - SAMARITAN FAMILY HEALTH NETWORK PAIN CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330157A
Medicare Provider Number
330157
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2020
Participating Start Date
10/1/2020
Participating Approval Date
7/16/2020
Last Recertification Date
8/15/2024
Termination Date
Termination Reason
4/1/2025
Business decision by the Covered Entity
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
826 Washington Street
Watertown, NY 13601
Billing Address
Samaritan Medical Center Pain Center Clinic
830 Washington Street
Watertown, NY 13601
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session