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GENOA HEALTHCARE LLC
DSH330101 NEW YORK-PRESBYTERIAN HOSPITAL
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Covered Entity Details
Entity Name
NEW YORK-PRESBYTERIAN HOSPITAL
Subdivision Name
UNIVERSITY HOSP OF COLUMBIA & CORNELL
Type
Disproportionate Share Hospital
340B ID
DSH330101
Entity Address
525 East 68th Street
New York, NY 10065
Medicare Provider Number
330101
Participating Start Date
4/1/2003
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
GENOA HEALTHCARE LLC
Pharmacy Address
2431 6TH AVE STE P
TROY, NY 12180
Pharmacy Comments
Contract Details
Approval Date
4/13/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William Farrell, SVP, Finance
(212) 297-4358
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
4/13/2021
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