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JACOBI MEDICAL CENTER
DSH330080 LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)
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Covered Entity Details
Entity Name
LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330080
Entity Address
234 EAST 149TH ST
BRONX, NY 10451
Medicare Provider Number
330080
Participating Start Date
12/1/1992
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
JACOBI MEDICAL CENTER
Pharmacy Address
NYC-HEALTH & HOSP.CORP
ATTN: PHARMACY DEPARTMENT
1400 PELHAM PKWY SOUTH
BRONX, NY 10461
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
NYCH+H
Rosemarie Leighton, Director of Pharmacy
(718) 918-3089
Signed By Date
4/15/2020
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