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NORTH CENTRAL BRONX HOSPITAL
DSH330396 WOODHULL HOSPITAL CENTER
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Covered Entity Details
Entity Name
WOODHULL HOSPITAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330396
Entity Address
760 BROADWAY
MAIN ENTRANCE: 720 FLUSHING AV
BROOKLYN, NY 11206
Medicare Provider Number
330396
Participating Start Date
12/1/1992
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
NORTH CENTRAL BRONX HOSPITAL
Pharmacy Address
3424 KOSSUTH AVE
ATT PHARMACY DEPT
BRONX, NY 10467
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
4/17/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
North Centeral Bronx Hospital
Brian Connolly, Director of Pharmacy
(718) 519-3579
Signed By Date
4/15/2020
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