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HMB PHARMACY MANAGEMENT LLC
DSH330059G MONTEFIORE MEDICAL CENTER
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Covered Entity Details
Entity Name
MONTEFIORE MEDICAL CENTER
Subdivision Name
COMPREHENSIVE FAMILY CARE CENTER (CFCC)
Type
Disproportionate Share Hospital
340B ID
DSH330059G
Entity Address
1621 EASTCHESTER ROAD
BRONX, NY 10461
Medicare Provider Number
330059
Outpatient Facility Provider Number
Participating Start Date
4/1/2005
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
HMB PHARMACY MANAGEMENT LLC
Pharmacy Address
DBA METCARE RX#2
1515 BLONDELL AVE
BRONX, NY 10461
Pharmacy Comments
Contract Details
Approval Date
4/29/2010
Contract Begin Date
4/29/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOEL PERLMAN, CHIEF FINANCIAL OFFICER
(718) 920-7602
Contract Pharmacy Representative
ATUL SHAH, PRESIDENT / OWNER
(201) 600-1705
Signed By Date
4/22/2010
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