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WEGMANS FOOD MARKETS, INC.
DSH330157 SAMARITAN MEDICAL CENTER
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Covered Entity Details
Entity Name
SAMARITAN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330157
Entity Address
830 WASHINGTON STREET
WATERTOWN, NY 13601
Medicare Provider Number
330157
Participating Start Date
10/1/2020
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WEGMANS FOOD MARKETS, INC.
Pharmacy Address
2851 BROADWAY
ATTN: PHARMACY
CHEEKTOWAGA, NY 14227
Pharmacy Comments
Contract Details
Approval Date
7/16/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Maxine A Briggs, VP Of Fiscal Services/Chief Financial Officer
(315) 755-3605
Contract Pharmacy Representative
Wegmans
Joseph Morgante, Pharmacy Business Relation Manager
(585) 239-2046
Signed By Date
7/12/2020
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