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CATHOLIC HEALTH SYSTEM INFUSION PHARMACY
DSH330078AS SISTERS OF CHARITY HOSPITAL
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Covered Entity Details
Entity Name
SISTERS OF CHARITY HOSPITAL
Subdivision Name
Sisters Health Center Caritas - Sisters Health Center Caritas - Adult
Type
Disproportionate Share Hospital
340B ID
DSH330078AS
Entity Address
2625 Harlem Road
Suite 160
Cheektowaga, NY 14225
Medicare Provider Number
330078
Outpatient Facility Provider Number
Participating Start Date
4/1/2021
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
CATHOLIC HEALTH SYSTEM INFUSION PHARMACY
Pharmacy Address
D/B/A CATHOLIC HEALTH INFUSION PHARMACY
6350 TRANSIT RD
DEPEW, NY 14043
Pharmacy Comments
Contract Details
Approval Date
7/30/2021
Contract Begin Date
8/5/2021
Carve-In Effective Date
10/1/2021
Contract Comments
Contacts
Covered Entity Signing Official
Michael Osborne, Vice President, Finance
(716) 828-2011
Contract Pharmacy Representative
HomeCare - Catholic Health System
Joyce Markiewicz, President and CEO HomeCare
(716) 706-2305
Signed By Date
7/30/2021
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