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AMBER ENTERPRISES, INC
DSH330204 BELLEVUE HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
BELLEVUE HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330204
Entity Address
462 FIRST AVENUE @ 27TH STREET
D/B/A NYC HEALTH & HOSPITAL CORP
NEW YORK, NY 10016
Medicare Provider Number
330204
Participating Start Date
8/1/1993
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
AMBER ENTERPRISES, INC
Pharmacy Address
DBA AMBER SPECIALTY PHARMACY
323 NORRISTOWN RD STE 100
AMBLER, PA 19002-2757
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/25/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Amber Enterprises
Kelley Miller, 340B Program Manager
(402) 861-7560
Signed By Date
7/17/2018
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