340B Drug Pricing Program Database
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DSH330194P MAIMONIDES MEDICAL CENTER (Active)
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Main Details
Name
MAIMONIDES MEDICAL CENTER
Subdivision Name
MAIMONIDES CARDIOLOGY OUTPATIENT C
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330194P
Medicare Provider Number
330194
Outpatient Facility Provider Number
330194
Additional Details
Current Program Status
Active
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/4/2014
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Maimonides Medical Center
John Marshall, EVP MedAffair/Chair MedOfficer
(718) 283-8313
Primary Contact
Maimonides Medical Center
Yevgenia Bukher, Assistant Director, Pharmacy
(718) 283-7232
Addresses
Street Address
421 OCEAN PKWY
BROOKLYN, NY 11218-5132
Billing Address
Maimonides Medical Center
4802 Tenth Avenue
Brooklyn, NY 11219
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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