340B Drug Pricing Program Database
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DSH330188S Mount St. Mary's Hospital and Health Center (Active)
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Main Details
Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
Mount St. Mary's Primary Care - Upper - Primary Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330188S
Medicare Provider Number
330188
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/2/2024
Participating Start Date
4/1/2024
Participating Approval Date
3/5/2024
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Catholic Health System
Michael Osborne, Vice President, Finance
(716) 828-2011
Primary Contact
Catholic Health System
Selena Holody, Analyst, 340B Program
(716) 270-6981
Addresses
Street Address
5290 Military Road
Suite 8 Upper
Lewiston, NY 14092
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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