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SONRISA CORP
DSH330080 LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)
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Covered Entity Details
Entity Name
LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330080
Entity Address
234 EAST 149TH ST
BRONX, NY 10451
Medicare Provider Number
330080
Participating Start Date
12/1/1992
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
SONRISA CORP
Pharmacy Address
DBA: SAINT HELENA PHARMACY
755B E 149TH ST
BRONX, NY 10455
Pharmacy Comments
Contract Details
Approval Date
5/2/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Saint Helena Pharmacy
Wally Contreras, Owner
(718) 742-9500
Signed By Date
5/2/2018
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