340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LONG ISLAND JEWISH MEDICAL CENTER AT HOM
DSH330119B LENOX HILL HOSPITAL
Print
Covered Entity Details
Entity Name
LENOX HILL HOSPITAL
Subdivision Name
Northwell Greenwich Village Hospital - Emergency
Type
Disproportionate Share Hospital
340B ID
DSH330119B
Entity Address
30 7th Avenue
New York, NY 10011
Medicare Provider Number
330119
Outpatient Facility Provider Number
Participating Start Date
1/24/2022
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
LONG ISLAND JEWISH MEDICAL CENTER AT HOM
Pharmacy Address
VIVO HEALTH PHARMACY AT HOME
225 COMMUNITY DR STE 140
GREAT NECK, NY 11021-5506
Pharmacy Comments
Contract Details
Approval Date
11/20/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
1/1/2024
Contract Comments
Contacts
Covered Entity Signing Official
Michele L Cusack, Executive Vice President
(516) 321-6058
Contract Pharmacy Representative
Vivo Health
Scott Jacobson, COO
(508) 254-9792
Signed By Date
11/20/2023
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