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WEGMANS FOOD MARKETS, INC.
DSH330065 NIAGARA FALLS MEMORIAL MEDICAL CENTER
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Covered Entity Details
Entity Name
NIAGARA FALLS MEMORIAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330065
Entity Address
621-10TH STREET
NIAGARA FALLS, NY 14302
Medicare Provider Number
330065
Participating Start Date
10/1/2006
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WEGMANS FOOD MARKETS, INC.
Pharmacy Address
3135 NIAGARA FALLS BLVD
AMHERST, NY 14228
Pharmacy Comments
06/25/2012 changed address (was 3135 niagara falls Blvd)
Contract Details
Approval Date
5/11/2012
Contract Begin Date
5/11/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/20/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Raj Mehta, CFO/Vice President of Finance
(716) 278-4399
Contract Pharmacy Representative
William Strassburg, Vice President
(585) 463-4064
Signed By Date
5/10/2012
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