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WEGMANS FOOD MARKETS, INC.
DSH330065A NIAGARA FALLS MEMORIAL MEDICAL CENTER
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Covered Entity Details
Entity Name
NIAGARA FALLS MEMORIAL MEDICAL CENTER
Subdivision Name
SUMMIT HEALTH FAMILY PRACTICE
Type
Disproportionate Share Hospital
340B ID
DSH330065A
Entity Address
6932-6934 WILLIAMS RD
200
Niagara Falls, NY 14304
Medicare Provider Number
330065
Outpatient Facility Provider Number
Participating Start Date
7/1/2007
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WEGMANS FOOD MARKETS, INC.
Pharmacy Address
1577 MILITARY ROAD
ATTN: PHARMACY
NIAGARA FALLS, NY 14304
Pharmacy Comments
Contract Details
Approval Date
9/25/2009
Contract Begin Date
9/25/2009
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
JULIE LENHARD, MANAGER, MANAGED CARE
(585) 239-2001
Signed By Date
8/21/2009
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