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CVS ALBANY, L.L.C.
DSH330193 FLUSHING HOSPITAL MEDICAL CENTER
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Covered Entity Details
Entity Name
FLUSHING HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330193
Entity Address
4500 PARSONS BLVD
PARSONS BLVD AND 45TH AVENUE
FLUSHING, NY 11355
Medicare Provider Number
330193
Participating Start Date
10/1/2004
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #5830
108-11 QUEENS BLVD
FOREST HILLS, NY 11375-4840
Pharmacy Comments
Contract Details
Approval Date
7/12/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Contract Pharmacy Representative
CVS Health
Robert F Brooks, Sr VP Health System Alliances
(401) 770-6195
Signed By Date
7/12/2021
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