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PHARMACY4HUMANITY
DSH330101 NEW YORK-PRESBYTERIAN HOSPITAL
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Covered Entity Details
Entity Name
NEW YORK-PRESBYTERIAN HOSPITAL
Subdivision Name
UNIVERSITY HOSP OF COLUMBIA & CORNELL
Type
Disproportionate Share Hospital
340B ID
DSH330101
Entity Address
525 East 68th Street
New York, NY 10065
Medicare Provider Number
330101
Participating Start Date
4/1/2003
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
PHARMACY4HUMANITY
Pharmacy Address
AHF PHARMACY
19300 S HAMILTON AVE STE 170-180
GARDENA, CA 90248
Pharmacy Comments
Contract Details
Approval Date
7/17/2024
Contract Begin Date
7/17/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/2/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
William Farrell, SVP, Finance
(212) 297-4358
Contract Pharmacy Representative
AIDS HEALTHCARE FOUNDATION
Scott Carruthers, Chief Pharmacy Officer
(323) 860-5200 Ext: 5266
Signed By Date
7/17/2024
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