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NEW YORK CITY HEALTH AND HOSPITAL CORPOR
DSH330202 KINGS COUNTY HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
KINGS COUNTY HOSPITAL CENTER (NYCHHC)
Subdivision Name
MAIN
Type
Disproportionate Share Hospital
340B ID
DSH330202
Entity Address
451 CLARKSON AVE.
BROOKLYN, NY 11203
Medicare Provider Number
330202
Participating Start Date
12/1/1992
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
NEW YORK CITY HEALTH AND HOSPITAL CORPOR
Pharmacy Address
RENAISSANCE HEALTH CARE NETWORK
264 W 118TH ST
NEW YORK, NY 10026-1620
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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