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CATHOLIC HEALTH SYSTEM INFUSION PHARMACY
DSH330078Y SISTERS OF CHARITY HOSPITAL
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Covered Entity Details
Entity Name
SISTERS OF CHARITY HOSPITAL
Subdivision Name
St. Joseph Campus-Operating Room
Type
Disproportionate Share Hospital
340B ID
DSH330078Y
Entity Address
2605 Harlem Road
Cheektowaga, NY 14225
Medicare Provider Number
330078
Outpatient Facility Provider Number
330078
Participating Start Date
1/1/2014
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
CATHOLIC HEALTH SYSTEM INFUSION PHARMACY
Pharmacy Address
D/B/A CATHOLIC HEALTH INFUSION PHARMACY
6350 TRANSIT RD
DEPEW, NY 14043
Pharmacy Comments
Contract Details
Approval Date
6/27/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
7/1/2018
Contract Comments
Contacts
Covered Entity Signing Official
Michael Osborne, Vice President, Finance
(716) 828-2011
Contract Pharmacy Representative
HomeCare - Catholic Health System
Joyce Markiewicz, President and CEO HomeCare
(716) 706-2305
Signed By Date
6/27/2018
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