340B Drug Pricing Program Database
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DSH330059EN MONTEFIORE MEDICAL CENTER (Active)
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Main Details
Name
MONTEFIORE MEDICAL CENTER
Subdivision Name
Wakefield Campus - Physical Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH330059EN
Medicare Provider Number
330059
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/20/2020
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Montefiore Medical Center
Ruth Cassidy, Vice President and Chief Pharmacy Officer
(718) 920-7887
Primary Contact
Montefiore Medical Center
Jessica Davidow, Assistant Director
(914) 904-4468
Addresses
Street Address
600 East 233rd Street
Bronx, NY 10466
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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