340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
NOBLE HEALTH SERVICES, INC
DSH330197 CANTON-POTSDAM HOSPITAL
Print
Covered Entity Details
Entity Name
CANTON-POTSDAM HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330197
Entity Address
50 LEROY STREET
POTSDAM, NY 13676
Medicare Provider Number
330197
Participating Start Date
1/1/2009
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
NOBLE HEALTH SERVICES, INC
Pharmacy Address
31 E MAIN ST
GOUVERNEUR, NY 13642
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
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
KPH Healthcare Services, Inc.
Debbi Barber, 340B Program Director
(315) 287-3600 Ext: 2423
Signed By Date
1/16/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session