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TOTAL CARE PHARMACY
DSH330385 NORTH CENTRAL BRONX HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
NORTH CENTRAL BRONX HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330385
Entity Address
3424 KOSSUTH AVE.
BRONX, NY 10467
Medicare Provider Number
330385
Participating Start Date
12/1/1992
Last Recertification Date
8/16/2021
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
TOTAL CARE PHARMACY
Pharmacy Address
4531 3RD AVE
BRONX, NY 10458
Pharmacy Comments
Contract Details
Approval Date
4/10/2013
Contract Begin Date
4/10/2013
Carve-In Effective Date
Contract Comments
04/10/2013 - Public health emergency declared in NY effective 10/27/2012
Contract Termination Date
Termination Reason
9/21/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Antonio Martin, Ececutive Vice President & Chief Operating Officier
(212) 788-3479
Contract Pharmacy Representative
Tony Sementilli, Owner
(718) 933-9900
Signed By Date
4/10/2013
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