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FQHCLA334AF NEW YORK CITY HEALTH AND HOSPITALS CORPORATION (Terminated)
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Main Details
Name
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Subdivision Name
Roberto Clemente/Sylvia Del Villard Health Center
Type
Health Center Program Look-Alike
Site ID
BPS-LAL-014622
340B ID
FQHCLA334AF
Grant Number
LALCS00169
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2015
Participating Start Date
7/1/2015
Participating Approval Date
4/22/2015
Last Recertification Date
2/21/2018
Termination Date
Termination Reason
4/1/2019
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
540 E 13th St
New York, NY 10009-3519
Billing Address
Gouverneur Healthcare Services
227 Madison Street
New York, NY 10002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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June 2025
June 2025
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