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CATHOLIC HEALTH SYSTEM INFUSION PHARMACY
DSH330188F Mount St. Mary's Hospital and Health Center
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Covered Entity Details
Entity Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
Clinic for Complete Senior Care Center
Type
Disproportionate Share Hospital
340B ID
DSH330188F
Entity Address
1302 Main Street
Niagara Falls, NY 14301
Medicare Provider Number
330188
Outpatient Facility Provider Number
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
12/23/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
1/1/2020
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
12/23/2019
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