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BRONX-MORRISANIA AMBULATORY
CH02426A BronxCare Health Integrated Services System, Inc.
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Covered Entity Details
Entity Name
BronxCare Health Integrated Services System, Inc.
Subdivision Name
BronxCare Dr. Martin Luther King, Jr. Health Center
Type
HRSA-Funded Health Center
340B ID
CH02426A
Entity Address
1265 Franklin Avenue
BRONX, NY 10456-3501
Grant Number
H80CS00625
Participating Start Date
7/1/2007
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BRONX-MORRISANIA AMBULATORY
Pharmacy Address
CARE UNIT-ATTN: PHARMACY DEPT
OF BRONX-LEBANON HOSPITAL CTR
1276 FULTON AVE 6TH FLOOR
BRONX, NY 10456
Pharmacy Comments
Contract Details
Approval Date
1/15/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/9/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
LIONEL P. STEWART, EXECUTIVE DIRECTOR
(718) 466-6072
Contract Pharmacy Representative
Bronx-Lebanon Hospital Center
Lawrence Schiller, Director of Pharmacy
(718) 518-5021
Signed By Date
1/15/2014
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