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DELIVER MY MEDS CORP.
DSH330350 UNIVERSITY HOSPITAL OF BROOKLYN
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Covered Entity Details
Entity Name
UNIVERSITY HOSPITAL OF BROOKLYN
Subdivision Name
SUNY DOWNSTATE MEDICAL CENTER
Type
Disproportionate Share Hospital
340B ID
DSH330350
Entity Address
445 LENOX ROAD
Attn: Pharmacy Box 36
BROOKLYN, NY 11203
Medicare Provider Number
330350
Participating Start Date
12/1/1992
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
DELIVER MY MEDS CORP.
Pharmacy Address
380 OSER AVE
HAUPPAUGE, NY 11788-3608
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Richard Bayard Miller, Chief Financial OIfficer
(718) 270-4901
Contract Pharmacy Representative
Express Health Mart Pharmacy Corp.
SHAHBAZ CHAUDHARY, Owner
(646) 463-2226 Ext: 6313236337
Signed By Date
4/15/2019
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