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CORAM HEALTHCARE CORPORATION OF GREATER
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
CORAM HEALTHCARE CORPORATION OF GREATER
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
2949 ERIE BLVD EAST
SUITE 103
SYRACUSE, NY 13224
Pharmacy Comments
Contract Details
Approval Date
10/14/2022
Contract Begin Date
10/18/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Frances Spreer Albert, Executive Vice President, COO and CFO
(518) 262-3579
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/14/2022
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