340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN EASTERN CO., INC.
SCH330223-01 MASSENA HOSPITAL, INC.
Print
Covered Entity Details
Entity Name
MASSENA HOSPITAL, INC.
Subdivision Name
MMH KIDS
Type
Sole Community Hospital
340B ID
SCH330223-01
Entity Address
17 HOSPITAL DR
MASSENA, NY 13662
Medicare Provider Number
330223
Outpatient Facility Provider Number
Participating Start Date
4/1/2017
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #10591
305 W. MAIN ST.
MALONE, NY 12953-1751
Pharmacy Comments
Contract Details
Approval Date
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Patrick Facteau, CFO
(315) 769-4207
Contract Pharmacy Representative
BRYAN TROMBLEY, 340 B, PHARMACIST
(518) 483-9090
Signed By Date
7/13/2017
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