340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH330180BA SAMARITAN HOSPITAL (Terminated)
Print
Main Details
Name
SAMARITAN HOSPITAL
Subdivision Name
Troy Surgery Associates - Surgery Services
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330180BA
Medicare Provider Number
330180
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/4/2020
Last Recertification Date
8/27/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
Samaritan Hospital of Troy NY
Lori Santos, CFO
(518) 525-5537
Primary Contact
Samaritan Hospital
Dario Pantano, Pharmacy Manager
(518) 271-3454
Addresses
Street Address
1 Tallow Wood Dr.
Clifton Park, NY 12065
Billing Address
Same as Street Address
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