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DSH330127 JACOBI MEDICAL CENTER (NYCHHC) (Active)
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Main Details
Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
FORMERLY BRONX MUNICIPAL HOSPITAL
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330127
Medicare Provider Number
330127
Additional Details
Current Program Status
Active
Registration Date
9/12/2007
Participating Start Date
12/1/1992
Participating Approval Date
9/14/2007
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
NYC Health + Hospitals
Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446
Primary Contact
NYC Health + Hospitals
Mark Capuano, Senior Director, Corporate Pharmacy 340B Program
(347) 835-9198
Addresses
Street Address
1400 PELHAM PKWY SOUTH
BRONX, NY 10461
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/4/05 UPADATED ADDR(WAS PELHAM PKWY & EASTCHESTER)
01/22/2010
May 2025
May 2025
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