340B Drug Pricing Program Database
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DSH330009AC BronxCare Health System (Active)
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Main Details
Name
BronxCare Health System
Subdivision Name
Health and Wellness Center - Center for Gynecologic Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330009AC
Medicare Provider Number
330009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/19/2018
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Bronx Lebanon Hospital Center
VICTOR DEMARCO, CFO
(718) 901-8600
Primary Contact
BronxCare Health System
Kyoung-Sil Kang, Director of Pharmacy
(718) 518-5021
Addresses
Street Address
199 Mt Eden Parkway, 3rd Floor
Bronx, NY 10457
Billing Address
BronxCare Health System
1276 Fulton Ave
Bronx, NY 10456
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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