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VITAL SERVICES LLC
DSH330078 SISTERS OF CHARITY HOSPITAL
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Covered Entity Details
Entity Name
SISTERS OF CHARITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330078
Entity Address
2157 MAIN STREET
BUFFALO, NY 14214
Medicare Provider Number
330078
Participating Start Date
1/1/2014
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
VITAL SERVICES LLC
Pharmacy Address
DBA VITAL PHARMACY
301 CONNECTICUT ST
BUFFALO, NY 14213
Pharmacy Comments
Contract Details
Approval Date
6/3/2021
Contract Begin Date
6/7/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Osborne, Vice President, Finance
(716) 828-2011
Contract Pharmacy Representative
Vital Services LLC
Joseph Bellava, Pharmacy Operations Director
(716) 390-5369
Signed By Date
6/3/2021
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