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NOBLE HEALTH SERVICES INC.
DSH330285 STRONG MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
STRONG MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330285
Entity Address
601 Elmwood Avenue
ROCHESTER, NY 14642
Medicare Provider Number
330285
Participating Start Date
10/1/2003
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
NOBLE HEALTH SERVICES INC.
Pharmacy Address
6040 TARBELL ROAD
SYRACUSE, NY 13206
Pharmacy Comments
Contract Details
Approval Date
4/14/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Segerson, Director of Finance
(585) 341-6686
Contract Pharmacy Representative
Debbi Barber, Director of PBM Relations
(315) 287-3600 Ext: 2423
Signed By Date
4/14/2016
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