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DBG SECURITY DRUGS INC.
DSH330385 NORTH CENTRAL BRONX HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
NORTH CENTRAL BRONX HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330385
Entity Address
3424 KOSSUTH AVE.
BRONX, NY 10467
Medicare Provider Number
330385
Participating Start Date
12/1/1992
Last Recertification Date
8/16/2021
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
DBG SECURITY DRUGS INC.
Pharmacy Address
D/B/A SECURITY DRUGS
3419 BOSTON RD
BRONX, NY 10469
Pharmacy Comments
Contract Details
Approval Date
7/1/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
DBG Security Drugs
Natwar Gevaria, Owner
(718) 654-6974
Signed By Date
7/1/2019
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