340B Drug Pricing Program Database
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DSH330009AQ BronxCare Health System (Active)
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Main Details
Name
BronxCare Health System
Subdivision Name
BronxCare Life Recovery Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330009AQ
Medicare Provider Number
330009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/26/2018
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
1285 Fulton Ave, 1st and 2nd Floor
Bronx, NY 10456
Billing Address
BronxCare Health System
1276 Fulton Ave
Bronx, NY 10456
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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