340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
TRINITY HEALTH PHARMACY SERVICES, LLC
DSH330180 SAMARITAN HOSPITAL
Print
Covered Entity Details
Entity Name
SAMARITAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330180
Entity Address
2215 BURDETT AVE
TROY, NY 12180
Medicare Provider Number
330180
Participating Start Date
1/1/2019
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
TRINITY HEALTH PHARMACY SERVICES, LLC
Pharmacy Address
12279 BLUFFTON RD
FORT WAYNE, IN 46809-3208
Pharmacy Comments
Contract Details
Approval Date
4/6/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lori Santos, CFO
(518) 525-5537
Contract Pharmacy Representative
TRINITY HEALTH
ZACHARY ROBERTS, DIRECTOR OF SPECIALTY PHARMACY
(734) 343-7606
Signed By Date
4/6/2022
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