Contract Pharmacy Details

THE GOLUB CORPORATION
DSH330013 ALBANY MEDICAL CENTER HOSPITAL

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

THE GOLUB CORPORATION

Pharmacy Address

PRICE CHOPPER PHARMACY 191
442 BALLTOWN ROAD
SCHENECTADY, NY 12304

Pharmacy Comments

Contract Details

Approval Date

10/14/2022

Contract Begin Date

10/18/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Frances Spreer Albert, Executive Vice President, COO and CFO
(518) 262-3579

Contract Pharmacy Representative

Golub Corporation
Scott Guisinger, Vice President of Pharmacy
(518) 379-2409

Signed By Date

10/14/2022

340B Drug Pricing Program Database