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RW410422 North Shore University Hospital (Active)
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Main Details
Name
North Shore University Hospital
Subdivision Name
Type
Ryan White Part D
340B ID
RW410422
Grant Number
H12HA24869
Additional Details
Current Program Status
Active
Registration Date
11/23/2011
Participating Start Date
12/15/2011
Participating Approval Date
12/15/2011
Last Recertification Date
2/11/2025
Time Period the Assistance was Received
8/1/2019 - 7/31/2026
Contacts
Authorizing Official
Northwell Health
Michele L Cusack, Executive Vice President
(516) 321-6058
Primary Contact
Northwell Health
David W. Rosenthal, Medical Director
(516) 622-5070
Addresses
Street Address
865 Northern Blvd
Ste 101
Great Neck, NY 11021
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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April 2025
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