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THE GOLUB CORPORATION
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
THE GOLUB CORPORATION
Pharmacy Address
MARKET 32 PHARMACY 003
716 HOOSICK RD
TROY, NY 12180
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
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