340B Drug Pricing Program Database
MMC PHARMACY INC
DSH330194N MAIMONIDES MEDICAL CENTER - information as of 5/7/2025 10:53:58 PM
Covered Entity Details
Entity Name
MAIMONIDES MEDICAL CENTER
Subdivision Name
Maimonides Breast Center
Type
Disproportionate Share Hospital
340B ID
DSH330194N
Entity Address
745 64th Street
Brooklyn, NY 11220-4753
Medicare Provider Number
330194
Outpatient Facility Provider Number
Participating Start Date
1/14/2013
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
MMC PHARMACY INC
Pharmacy Address
948 48TH ST
BROOKLYN, NY 11219-2918
Pharmacy Comments
Contract Details
Approval Date
10/9/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
1/1/2024
Contract Comments
Contacts
Covered Entity Signing Official
John P Marshall, Chief Medical Officer
(718) 283-6028
Contract Pharmacy Representative
MMC Pharmacy
Neal Neumann, Director of Pharmacy and Compliance
(718) 283-8473
Signed By Date
10/9/2023
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