340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RITE AID OF NEW YORK, INC.
DSH330014 JAMAICA HOSPITAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
JAMAICA HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330014
Entity Address
8900 VAN WYCK EXPRESSWAY
JAMAICA, NY 11418
Medicare Provider Number
330014
Participating Start Date
10/1/2004
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #4274
90-01 SUTPHIN BOULEVARD
JAMAICA, NY 11435
Pharmacy Comments
Contract Details
Approval Date
7/3/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/27/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/3/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session