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DRUG MART SOLUTIONS LLC
DSH330169 MOUNT SINAI BETH ISRAEL
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Covered Entity Details
Entity Name
MOUNT SINAI BETH ISRAEL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330169
Entity Address
FIRST AVENUE AT 16TH STREET
NEW YORK, NY 10003
Medicare Provider Number
330169
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
DRUG MART SOLUTIONS LLC
Pharmacy Address
D/B/A QUALITY RX
1611 UNIVERSITY AVENUE
BRONX, NY 10453
Pharmacy Comments
Contract Details
Approval Date
7/14/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/9/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Michael Bruno, Sr. Vice President
(212) 523-7140
Contract Pharmacy Representative
Charles Rabinovich, Director of Corporate Operations
(800) 490-1755
Signed By Date
7/14/2016
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