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GENOVESE DRUG STORES, INC.
DSH330055 NEWYORK-PRESBYTERIAN / QUEENS
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Covered Entity Details
Entity Name
NEWYORK-PRESBYTERIAN / QUEENS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330055
Entity Address
56-45 MAIN STREET
FLUSHING, NY 11355
Medicare Provider Number
330055
Participating Start Date
4/1/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
GENOVESE DRUG STORES, INC.
Pharmacy Address
RITE AID #10591
193-01 NORTHERN BLVD.
AUBURNDALE, NY 11358
Pharmacy Comments
Contract Details
Approval Date
10/18/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/18/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
FRANCIS HAGAN, VP FOR FINANCE
(718) 670-1971
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/18/2013
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