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DUANE READE
DSH330204 BELLEVUE HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
BELLEVUE HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330204
Entity Address
462 FIRST AVENUE @ 27TH STREET
D/B/A NYC HEALTH & HOSPITAL CORP
NEW YORK, NY 10016
Medicare Provider Number
330204
Participating Start Date
8/1/1993
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
DUANE READE
Pharmacy Address
13602 ROOSEVELT AVENUE
FLUSHING, NY 11354
Pharmacy Comments
11/02/2012 DEA check, name update (was Walgreens #14438)
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2023
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