340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
TERESA PHARMA LLC
DSH330233 BROOKDALE HOSPITAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
BROOKDALE HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330233
Entity Address
ONE BROOKDALE PLAZA
BROOKLYN, NY 11212
Medicare Provider Number
330233
Participating Start Date
10/1/2004
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
TERESA PHARMA LLC
Pharmacy Address
582 ROCKAWAY AVE
BROOKLYN, NY 11212
Pharmacy Comments
Contract Details
Approval Date
6/8/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Robert A. Palermo, CFO
(718) 240-8515
Contract Pharmacy Representative
TERESA PHARMA LLC
Karan Patel, Owner
(718) 342-3446
Signed By Date
6/8/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session