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CITY DRUGS NY CORP.
DSH330056 THE BROOKLYN HOSPITAL CENTER
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Covered Entity Details
Entity Name
THE BROOKLYN HOSPITAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330056
Entity Address
121 DEKALB AVE
BROOKLYN, NY 11201
Medicare Provider Number
330056
Participating Start Date
4/1/2005
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
CITY DRUGS NY CORP.
Pharmacy Address
D/B/A CITY DRUGS
1551 YORK AVE
NEW YORK, NY 10028-6022
Pharmacy Comments
Contract Details
Approval Date
1/11/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/7/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Donald P. Minarcik, VP Revenue Enhancement
(718) 488-3775
Contract Pharmacy Representative
City Drugs NY Corp.
Alex Zeygeril, CEO
(212) 988-4500
Signed By Date
1/11/2019
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