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BRANAC INC
DSH330196 NYC Health + Hospitals/South Brooklyn Health
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Covered Entity Details
Entity Name
NYC Health + Hospitals/South Brooklyn Health
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330196
Entity Address
2601 OCEAN PARKWAY
BROOKLYN, NY 11235
Medicare Provider Number
330196
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
BRANAC INC
Pharmacy Address
CONEY ISLAND PHARMACY
2720 MERMAID AVENUE
BROOKLYN, NY 11224-2006
Pharmacy Comments
Contract Details
Approval Date
6/25/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Branac Inc.
Elena Ivanova, COO
(212) 249-8202
Signed By Date
6/25/2020
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