Contract Pharmacy Details

MOSUZ INC
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS

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

MOSUZ INC

Pharmacy Address

DBA: BELMONT PHARMACY
102 A BELMONT AVE
BROOKLYN, NY 11212-1121

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

2/28/2019
Ownership change

Contacts

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Contract Pharmacy Representative

Mosuz Inc
Veera Indana, POC
(718) 485-3300

Signed By Date

10/15/2018

340B Drug Pricing Program Database