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PARKARE PHARMACY INC
DSH330127 JACOBI MEDICAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
FORMERLY BRONX MUNICIPAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH330127
Entity Address
1400 PELHAM PKWY SOUTH
BRONX, NY 10461
Medicare Provider Number
330127
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
PARKARE PHARMACY INC
Pharmacy Address
PARKARE PHARMACY, INC
2158 STARLING AVE
BRONX, NY 10462-4303
Pharmacy Comments
Contract Details
Approval Date
7/1/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Parkare Pharmacy
Mahua Rahman, President
(718) 239-3500
Signed By Date
7/1/2019
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