340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KINGS PARK SLOPE INC
DSH330169C MOUNT SINAI BETH ISRAEL
Print
Covered Entity Details
Entity Name
MOUNT SINAI BETH ISRAEL
Subdivision Name
MOUNT SINAI BROOKLYN
Type
Disproportionate Share Hospital
340B ID
DSH330169C
Entity Address
3201 KINGS HIGHWAY
BROOKLYN, NY 11234
Medicare Provider Number
330169
Outpatient Facility Provider Number
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
KINGS PARK SLOPE INC
Pharmacy Address
D/B/A KINGS SUPER PHARMACY
357 FLATBUSH AVE
BROOKLYN, NY 11238
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/27/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael Bruno, Sr. Vice President
(212) 523-7140
Contract Pharmacy Representative
Promesa, Inc.
Dimitry Vagman, Supervising Pharmacist
(718) 230-3535
Signed By Date
4/15/2016
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