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WEGMANS FOOD MARKETS, INC.
DSH330265 Clifton Springs Hospital
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Covered Entity Details
Entity Name
Clifton Springs Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330265
Entity Address
2 Coulter Road
Clifton Springs, NY 14432
Medicare Provider Number
330265
Participating Start Date
7/1/2012
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WEGMANS FOOD MARKETS, INC.
Pharmacy Address
2851 BROADWAY
ATTN: PHARMACY
CHEEKTOWAGA, NY 14227
Pharmacy Comments
Contract Details
Approval Date
7/18/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/14/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Donna Smith, VP of Operations
(315) 462-0100
Contract Pharmacy Representative
Wegmans
Joseph Morgante, Pharmacy Business Relation Manager
(585) 239-2046
Signed By Date
7/18/2019
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