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JAMAICARX, INC.
DSH330014 JAMAICA HOSPITAL MEDICAL CENTER
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Covered Entity Details
Entity Name
JAMAICA HOSPITAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330014
Entity Address
8900 VAN WYCK EXPRESSWAY
JAMAICA, NY 11418
Medicare Provider Number
330014
Participating Start Date
10/1/2004
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
JAMAICARX, INC.
Pharmacy Address
D/B/A MEDISYS RX PHARMACY
90-09 VAN WYCK EXPY
JAMAICA, NY 11435
Pharmacy Comments
Contract Details
Approval Date
7/5/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Contract Pharmacy Representative
jamaica
Halimur Khan, Supervising Pharmacist
(929) 499-3456
Signed By Date
7/5/2017
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