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AHG OF NEW YORK, INC
DSH330226 UNITY HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
UNITY HOSPITAL OF ROCHESTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330226
Entity Address
1555 LONG POND ROAD
ROCHESTER, NY 14626
Medicare Provider Number
330226
Participating Start Date
3/15/2022
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
AHG OF NEW YORK, INC
Pharmacy Address
DBA: ACCREDO
125 CLEARBROOK RD STE 122
ELMSFORD, NY 10523-1119
Pharmacy Comments
Contract Details
Approval Date
1/4/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shawn Bishop, Vice President, RRH Revenue & Reimbursement
(585) 922-0056
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
1/4/2024
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