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RRC330191-00 GLENS FALLS HOSPITAL (Terminated)
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Main Details
Name
GLENS FALLS HOSPITAL
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC330191-00
Medicare Provider Number
330191
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2020
Participating Start Date
8/18/2020
Participating Approval Date
7/21/2020
Last Recertification Date
9/15/2021
Termination Date
Termination Reason
10/1/2022
Change of covered entity type
Contacts
Authorizing Official
Glens Falls Hospital Inc.
Paul J Scimeca, Senior Vice President/Chief Operating Officer
(518) 926-5902
Primary Contact
Albany Med Health System
Alan W Slowick, System Associate Director of Pharmacy - 340B
(518) 926-2527
Addresses
Street Address
100 PARK ST
GLENS FALLS, NY 12801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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