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MELBRAN DRUGS INC
DSH330101 NEW YORK-PRESBYTERIAN HOSPITAL
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Covered Entity Details
Entity Name
NEW YORK-PRESBYTERIAN HOSPITAL
Subdivision Name
UNIVERSITY HOSP OF COLUMBIA & CORNELL
Type
Disproportionate Share Hospital
340B ID
DSH330101
Entity Address
525 East 68th Street
New York, NY 10065
Medicare Provider Number
330101
Participating Start Date
4/1/2003
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
MELBRAN DRUGS INC
Pharmacy Address
D/B/A MELBRAN PHARMACY
605 W 168TH ST
D B A MELBRAN PHARMACY
NEW YORK, NY 10032-3705
Pharmacy Comments
Contract Details
Approval Date
10/9/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William Farrell, SVP, Finance
(212) 297-4358
Contract Pharmacy Representative
Melbran Pharmacy
Kumar Suraneni, Owner
(212) 568-1300
Signed By Date
10/9/2018
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