340B Drug Pricing Program Database
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DSH330265C Clifton Springs Hospital (Active)
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Main Details
Name
Clifton Springs Hospital
Subdivision Name
CMG CANAL PARK FAMILY MEDICINE - Family Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330265C
Medicare Provider Number
330265
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/3/2020
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Rochester Regional Health
Shawn Bishop, Vice President, RRH Revenue & Reimbursement
(585) 922-0056
Primary Contact
RRH
Robert Michael Scardino, 340B Pharmacy System Manager
(585) 319-6750
Addresses
Street Address
1900 ROUTE 31
11
MACEDON, NY 14502-8995
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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