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DUANE READE
DSH330028 RICHMOND UNIVERSITY MEDICAL CENTER
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Covered Entity Details
Entity Name
RICHMOND UNIVERSITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330028
Entity Address
355 BARD AVENUE
STATEN ISLAND, NY 10310
Medicare Provider Number
330028
Participating Start Date
11/17/2005
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
DUANE READE
Pharmacy Address
436 86TH STREET
BROOKLYN, NY 11209
Pharmacy Comments
Contract Details
Approval Date
4/8/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Murphy, CFO
(718) 818-3295
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/8/2014
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