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RRC330140-00 ST. JOSEPHS HOSPITAL HEALTH CENTER (Active)
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Main Details
Name
ST. JOSEPHS HOSPITAL HEALTH CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC330140-00
Medicare Provider Number
330140
Additional Details
Current Program Status
Active
Registration Date
7/1/2021
Participating Start Date
10/1/2021
Participating Approval Date
8/19/2021
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
St. Joseph's Hospital Health Center
Meredith Anne Price, Chief Financial Officer
(315) 448-5888
Primary Contact
St. Joseph's Hospital Health Center
Bernie E Delello, Director Pharmacy
(315) 448-5199
Addresses
Street Address
301 PROSPECT AVENUE
SYRACUSE, NY 13203
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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