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TOPS PT, LLC
DSH330115 ONEIDA HEALTHCARE CENTER
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Covered Entity Details
Entity Name
ONEIDA HEALTHCARE CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330115
Entity Address
321 GENESEE STREET
ONEIDA, NY 13421
Medicare Provider Number
330115
Participating Start Date
1/1/2015
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
TOPS PT, LLC
Pharmacy Address
87 EAST STATE STREET
SHERRILL, NY 13461
Pharmacy Comments
Contract Details
Approval Date
12/9/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Milligan, CFO
(315) 361-2088
Contract Pharmacy Representative
Tops Markets
Brian Huckle, Director of Pharmacy
(716) 635-5275
Signed By Date
12/9/2014
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