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WESTERN NEW YORK BLOODCARE INC
HM6925 MARY M. GOOLEY HEMOPHILIA CENTER INC.
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Covered Entity Details
Entity Name
MARY M. GOOLEY HEMOPHILIA CENTER INC.
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM6925
Entity Address
1415 PORTLAND AVE.
SUITE 500
ROCHESTER, NY 14621
Grant Number
H30MC24048
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WESTERN NEW YORK BLOODCARE INC
Pharmacy Address
1010 MAIN ST STE 300
BUFFALO, NY 14202-1102
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Wilmarth, President & CEO
(585) 922-5700
Contract Pharmacy Representative
Western New York BloodCare
Laurel A Reger, Executive Director
(716) 896-2470 Ext: 4001
Signed By Date
4/15/2020
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