Contract Pharmacy Details

PARKWAY DRUGS OF ONEIDA CO
DSH330044 MVHS, Inc. DBA: Wynn Hospital

Covered Entity Details

Entity Name

MVHS, Inc. DBA: Wynn Hospital

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH330044

Entity Address

111 Hospital Drive
Utica, NY 13502

Medicare Provider Number

330044

Participating Start Date

7/1/2014

Last Recertification Date

9/5/2024

Pharmacy Details

Pharmacy Name

PARKWAY DRUGS OF ONEIDA CO

Pharmacy Address

1256 ALBANY ST
UTICA, NY 13501

Pharmacy Comments

Contract Details

Approval Date

4/25/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Louis Aiello, Sr. VP Finance/ CFO
(315) 624-6143

Contract Pharmacy Representative

Signed By Date

4/25/2014

340B Drug Pricing Program Database