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DSH330073X UNITED MEMORIAL MEDICAL CENTER (Terminated)
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Main Details
Name
UNITED MEMORIAL MEDICAL CENTER
Subdivision Name
UMMC ENDOCRINOLOGY CENTER - Endocrinology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330073X
Medicare Provider Number
330073
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/17/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/7/2023
Last Recertification Date
Termination Date
Termination Reason
1/1/2024
Site closure
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
16 BANK ST
BATAVIA, NY 14020
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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