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MORRISANIA DIAGNOSTIC AND TREATMENT CENT
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
MORRISANIA DIAGNOSTIC AND TREATMENT CENT
Pharmacy Address
NEW YORK CITY HEALTH AND HOSPITAL CORPOR
1225 GERARD AVE
BRONX, NY 10452
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
NYCH+H
Young Kum, Director of Pharmacy
(718) 960-2772
Signed By Date
7/17/2018
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