340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PINEBROOK RX INC.
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS
Print
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
PINEBROOK RX INC.
Pharmacy Address
DBA: PINEBROOK PHARMACY
1183 JEROME AVE
BRONX, NY 10452
Pharmacy Comments
Contract Details
Approval Date
10/16/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/2/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Pinebrook Rx
Ravi Mamidela, Owner
(718) 992-8182
Signed By Date
10/16/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session