340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
VINCE'S PHARMACY OF CAMILLUS
DSH330241 UNIVERSITY HOSPITAL
Print
Covered Entity Details
Entity Name
UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330241
Entity Address
750 East Adams Street
Syracuse, NY 13210
Medicare Provider Number
330241
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
VINCE'S PHARMACY OF CAMILLUS
Pharmacy Address
DBA MEDICINE SHOPPE
240 TOWNSHIP BLVD STE 30
CAMILLUS, NY 13031-1793
Pharmacy Comments
Contract Details
Approval Date
10/1/2021
Contract Begin Date
1/1/2022
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
Stuart M. Wright, Chief Financial Officer
(315) 464-5179
Contract Pharmacy Representative
The Medicine Shoppe
Michael Machen, President
(315) 487-5775
Signed By Date
10/1/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session