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EAST NEW YORK DIAGNOSTIC AND TREATMENT C
DSH330240 HARLEM HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
HARLEM HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330240
Entity Address
506 LENOX AVENUE
NEW YORK, NY 10037
Medicare Provider Number
330240
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
EAST NEW YORK DIAGNOSTIC AND TREATMENT C
Pharmacy Address
DIV OF NYC HEALTH & HOSP CORP
2094 PITKIN AVE
BROOKLYN, NY 11207
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
New York City Health and Hospitals
Min Than, Assistant Vice President
(212) 442-3854
Signed By Date
7/15/2021
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