340B Drug Pricing Program Database
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DSH330214EY NYU Langone Hospitals (Terminated)
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Main Details
Name
NYU Langone Hospitals
Subdivision Name
NYU Langone Hospital - Long Island Blood Draw Station
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330214EY
Medicare Provider Number
330214
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/11/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/6/2019
Last Recertification Date
9/12/2022
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
NYU Langone Health
Daniel J Widawsky, Chief Financial Officer
(212) 263-3092
Primary Contact
NYU Langone Health
Kristopher DaCosta, Director of 340B and Pharmacy Business & Analytics
(646) 754-9356
Addresses
Street Address
222 Station Plaza
Mineola, NY 11501
Billing Address
NYU Langone Hospitals
PO Box 427
Elmsford, NY 10523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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