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DSH330090AJ ARNOT OGDEN MEDICAL CENTER (Active)
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Main Details
Name
ARNOT OGDEN MEDICAL CENTER
Subdivision Name
Southport Internal Medicine AOMC - Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330090AJ
Medicare Provider Number
330090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/7/2022
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Arnot Ogden Medical Center
Ronette Wiley, Senior Vice President and Chief Operating Officer
(607) 737-4486
Primary Contact
Arnot Ogden Medical Center
Rebecca Sue Carr-Reynolds, Interim Systems Director of Pharmacy
(607) 737-4283
Addresses
Street Address
200 Madison Ave
3rd Floor
Elmira, NY 14901
Billing Address
Arnot Ogden Medical Center
600 Roe Ave
Elmira, NY 14905
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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