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WEGMANS FOOD MARKETS, INC.
DSH330238 NICHOLAS H. NOYES MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
NICHOLAS H. NOYES MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330238
Entity Address
111 CLARA BARTON STREET
DANSVILLE, NY 14437
Medicare Provider Number
330238
Participating Start Date
10/1/2017
Last Recertification Date
8/15/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
WEGMANS FOOD MARKETS, INC.
Pharmacy Address
1000 HIGHWAY 36 NORTH
ATTN: PHARMACY
HORNELL, NY 14843
Pharmacy Comments
01/25/2013 name update, DEA normalization (was Wegmans Pharmacy #017)
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/29/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jay Maslyn, CFO
(585) 335-4306
Contract Pharmacy Representative
Wegmans
Joseph Morgante, Pharmacy Business Relation Manager
(585) 239-2046
Signed By Date
7/17/2018
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