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DULARI CORP.
DSH330014A JAMAICA HOSPITAL MEDICAL CENTER
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Covered Entity Details
Entity Name
JAMAICA HOSPITAL MEDICAL CENTER
Subdivision Name
THE JAMAICA HOSPITAL WOMEN'S HEALTH CENTER
Type
Disproportionate Share Hospital
340B ID
DSH330014A
Entity Address
133-03 JAMAICA AVENUE
RICHMOND HILLS, NY 11418
Medicare Provider Number
330014
Outpatient Facility Provider Number
Participating Start Date
1/1/2007
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
DULARI CORP.
Pharmacy Address
QUEENS DRUGS & SURGICAL
146-14 JAMAICA AVE
ATTN: SUPERVISING PHARMACIST
JAMAICA, NY 11435-3628
Pharmacy Comments
Contract Details
Approval Date
1/11/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Contract Pharmacy Representative
Jamaica
Samir Sutaria, Pharmacist
(718) 297-0099
Signed By Date
1/11/2019
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