340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
31ST & 3RD PHARMACY INC
DSH330188L Mount St. Mary's Hospital and Health Center
Print
Covered Entity Details
Entity Name
Mount St. Mary's Hospital and Health Center
Subdivision Name
Cardiac Center - Cardiopulmonary
Type
Disproportionate Share Hospital
340B ID
DSH330188L
Entity Address
5290 Military Road
Suite 10A
Lewiston, NY 14092
Medicare Provider Number
330188
Outpatient Facility Provider Number
Participating Start Date
1/1/2019
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
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
Paramount SPecialty
Al DosSantos, Founding Principle
(631) 815-5776
Signed By Date
12/23/2019
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