340B Drug Pricing Program Database
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DSH330127D JACOBI MEDICAL CENTER (NYCHHC) (Active)
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Main Details
Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
NCB _ Recovery Room - Recovery Room
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH330127D
Medicare Provider Number
330127
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2021
Participating Start Date
4/22/2021
Participating Approval Date
4/22/2021
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
NYC Health + Hospitals
Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446
Primary Contact
NYC Health + Hospitals
Mark Capuano, Senior Director, Corporate Pharmacy 340B Program
(347) 835-9198
Addresses
Street Address
3424 Kossuth Avenue
Recovery Room
Bronx
Bronx, NY 10467
Billing Address
Jacobi Medical Center (NYCHHC)
1400 Pelham Parkway
Bronx, NY 10461
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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