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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
2873 BROADWAY ST
SUITE 100
CHEEKTOWAGA, NY 14227-1036
Pharmacy Comments
Contract Details
Approval Date
2/12/2021
Contract Begin Date
2/12/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maxine A Briggs, VP Of Fiscal Services/Chief Financial Officer
(315) 755-3605
Contract Pharmacy Representative
Wegmans Food Markets, Inc.
Tony Tartaro, Business Development Manager-Pharmacy
(585) 746-5059
Signed By Date
2/12/2021
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