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FIRST HEALTH SPECIALTY PHARMACY INC.
DSH330399 ST BARNABAS HOSPITAL
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Covered Entity Details
Entity Name
ST BARNABAS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330399
Entity Address
4422 THIRD AVENUE
BRONX, NY 10457
Medicare Provider Number
330399
Participating Start Date
1/1/2005
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
FIRST HEALTH SPECIALTY PHARMACY INC.
Pharmacy Address
754 E 151ST ST
BRONX, NY 10455-3267
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/12/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
Ruth E. Cassidy, Senior Vice President of Clinical Support Services and Chief Pharmacy Officer
(718) 960-6180
Contract Pharmacy Representative
First Health Specialty Pharmacy Inc.
Emil Trokel, President
(347) 783-7070
Signed By Date
1/14/2019
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