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ALBANY MEDICAL CENTER HOSPITAL
DSH330013 ALBANY MEDICAL CENTER HOSPITAL
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Covered Entity Details
Entity Name
ALBANY MEDICAL CENTER HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330013
Entity Address
43 NEW SCOTLAND AVENUE
ALBANY, NY 12208
Medicare Provider Number
330013
Participating Start Date
4/1/2006
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ALBANY MEDICAL CENTER HOSPITAL
Pharmacy Address
PHARMACY DEPARTMENT
43 NEW SCOTLAND AVE
ALBANY, NY 12208-3412
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
FERDINAND J. VENDITTI, EXECUTIVE VP FOR SYSTEM CARE DELIVERY
(518) 262-5376
Contract Pharmacy Representative
Albany Med Health System
Alan W Slowick, System Associate Director of Pharmacy - 340B
(518) 926-2527
Signed By Date
7/17/2017
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