340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS ALBANY, L.L.C.
DSH330127 JACOBI MEDICAL CENTER (NYCHHC)
Print
Covered Entity Details
Entity Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
FORMERLY BRONX MUNICIPAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH330127
Entity Address
1400 PELHAM PKWY SOUTH
BRONX, NY 10461
Medicare Provider Number
330127
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
CVS ALBANY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #8940
1688 WESTCHESTER AVE
BRONX, NY 10472
Pharmacy Comments
Contract Details
Approval Date
7/23/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Antonio Martin, Ececutive Vice President & Chief Operating Officier
(212) 788-3479
Contract Pharmacy Representative
CVS Rx Services, Inc
Jordan Birnbaum, 340B Vendor Manager
(401) 770-2241
Signed By Date
7/23/2014
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