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DSH330009AN BronxCare Health System (Terminated)
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Main Details
Name
BronxCare Health System
Subdivision Name
BronxCare Oncology Outpatient Program
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330009AN
Medicare Provider Number
330009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/26/2018
Last Recertification Date
Termination Date
Termination Reason
10/1/2019
Other
Contacts
Authorizing Official
Bronx Lebanon Hospital Center
VICTOR DEMARCO, CFO
(718) 901-8600
Primary Contact
Bronx-Lebanon Hospital Center
Lawrence Schiller, Director of Pharmacy
(718) 518-5021
Addresses
Street Address
1650 Selwyn Avenue, 1st 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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