340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ROCKAWAY RX INC.
DSH330233 BROOKDALE HOSPITAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
BROOKDALE HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330233
Entity Address
ONE BROOKDALE PLAZA
BROOKLYN, NY 11212
Medicare Provider Number
330233
Participating Start Date
10/1/2004
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
ROCKAWAY RX INC.
Pharmacy Address
DBA SAM KORF PHARMACY
710 ROCKAWAY AVE
BROOKLYN, NY 11212-5456
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diana Sullivan, VP
(718) 240-7449
Contract Pharmacy Representative
Rockawayrx pharmacy
Ghulam Sabir, President
(718) 498-3941
Signed By Date
4/13/2022
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