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DSH330127A JACOBI MEDICAL CENTER (NYCHHC) (Terminated)
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Main Details
Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
Gun Hill Health Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330127A
Medicare Provider Number
330127
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/30/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
11/7/2017
Termination Date
Termination Reason
7/1/2018
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
New York City Health and Hospitals
Paul Albertson, Vice President
(212) 748-2256
Primary Contact
New York City Health + Hospitals
Danielle Sestito, Senior Director, 340B Operations
(212) 442-3892
Addresses
Street Address
1012 East Gunhill Road
Bronx, NY 10469
Billing Address
Jacobi Medical Center
1400 Pelham Parkway S
Bronx, NY 10469
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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