340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
31ST & 3RD PHARMACY INC
DSH330188K Mount St. Mary's Hospital and Health Center
Print
Covered Entity Details
Entity Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
MOUNT ST MARY'S NEUROLOGY AND STROKE
Type
Disproportionate Share Hospital
340B ID
DSH330188K
Entity Address
4600 MILITARY RD
STE B
NIAGARA FALLS, NY 14305-1338
Medicare Provider Number
330188
Outpatient Facility Provider Number
Participating Start Date
10/1/2017
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
31ST & 3RD PHARMACY INC
Pharmacy Address
D/B/A AVITA PHARMACY 1063
1860 WALT WHITMAN RD STE 700
MELVILLE, NY 11747
Pharmacy Comments
Contract Details
Approval Date
6/27/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
7/1/2018
Contract Comments
Contract Termination Date
Termination Reason
2/3/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
Michael Osborne, Vice President, Finance
(716) 828-2011
Contract Pharmacy Representative
Paramount Pharmacy
John F. Civitello, 340B Program Director
(631) 815-5778
Signed By Date
6/27/2018
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