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ROSEBANK PHARMACY LLC
DSH330196 NYC Health + Hospitals/South Brooklyn Health
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Covered Entity Details
Entity Name
NYC Health + Hospitals/South Brooklyn Health
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330196
Entity Address
2601 OCEAN PARKWAY
BROOKLYN, NY 11235
Medicare Provider Number
330196
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ROSEBANK PHARMACY LLC
Pharmacy Address
500 TOMPKINS AVE.
STATEN ISLAND, NY 10305-1743
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/8/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Rosebank
Florence Levine, Owner
(718) 727-0426
Signed By Date
10/15/2018
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