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WEGMANS FOOD MARKETS, INC.
DSH330188 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
Type
Disproportionate Share Hospital
340B ID
DSH330188
Entity Address
5300 MILITARY ROAD
LEWISTON, NY 14092
Medicare Provider Number
330188
Participating Start Date
1/1/2014
Last Recertification Date
9/5/2024
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
2/26/2021
Contract Begin Date
2/26/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/10/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Osborne, Vice President, Finance
(716) 828-2011
Contract Pharmacy Representative
Wegmans Food Markets, Inc.
Tony Tartaro, Business Development Manager-Pharmacy
(585) 746-5059
Signed By Date
2/26/2021
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