340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH330059AI MONTEFIORE MEDICAL CENTER (Active)
Print
Main Details
Name
MONTEFIORE MEDICAL CENTER
Subdivision Name
MONTEFIORE MEDICAL CENTER - SOUTH B
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330059AI
Medicare Provider Number
330059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/29/2007
Participating Start Date
10/1/2017
Participating Approval Date
10/29/2007
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Montefiore Medical Center
Ruth Cassidy, Vice President and Chief Pharmacy Officer
(718) 920-7887
Primary Contact
Montefiore Medical Center
Jessica Davidow, Assistant Director
(914) 904-4468
Addresses
Street Address
871 PROSPECT AVE
BRONX, NY 10459-3913
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
2
of
2
Page:
of 1
Go
Page size:
Change
8/3/17 Participated starting 4/1/2005, terminated 7/1/2015. Reinstated 10/1/2017.
08/03/2017
3/31/10 DOC RECD TO CONFIRM ELIG NON-PROFIT STATUS
10/29/2007
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
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