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CH02426K BronxCare Health Integrated Services System, Inc. (Active)
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Main Details
Name
BronxCare Health Integrated Services System, Inc.
Subdivision Name
BronxCare Dental Services
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013572
340B ID
CH02426K
Grant Number
H80CS00625
Additional Details
Current Program Status
Active
Registration Date
4/2/2013
Participating Start Date
4/12/2013
Participating Approval Date
4/12/2013
Last Recertification Date
2/12/2025
Contacts
Authorizing Official
BronxCare Health Integrated Health Care Solutions
Crystal D Jordan, Executive Director
(718) 466-6072
Primary Contact
BronxCare Health System
Kyoung-Sil Kang, Director of Pharmacy
(718) 518-5021
Addresses
Street Address
1775 GRAND CONCOURSE
Bronx, NY 10453-8205
Billing Address
BronxCare Dental Services
1265 Franklin Avenue
Bronx, NY 10456
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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3/16/14 Corrected misapplied update during EHB reconciliation process. 4/12/13 IMMEDIATE START DATE DUE TO PUBLIC HEALTH EMERGENCY IN NY
03/16/2014
4/12/13 IMMEDIATE START DATE DUE TO PUBLIC HEALTH EMERGENCY IN NY
04/12/2013
June 2025
June 2025
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