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BROOKDALE PHARMA INC
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS
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Covered Entity Details
Entity Name
NEW YORK CITY HEALTH AND HOSPITALS
Subdivision Name
Cumberland Diagnostic and Treatment Center
Type
HRSA-Funded Health Center
340B ID
CHC29018-00
Entity Address
100 N Portland Ave
Brooklyn, NY 11205-2005
Grant Number
H80CS29018
Participating Start Date
4/1/2016
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
BROOKDALE PHARMA INC
Pharmacy Address
D/B/A BROOKDALE PHARMACY
2568 LINDEN BLVD
BROOKLYN, NY 11208-4904
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/22/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Brookdale Pharma Inc
Kalpeh Patel, Owner
(718) 485-0070
Signed By Date
10/12/2018
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