340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
NISAR PHARMACY INC
DSH330080 LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)
Print
Covered Entity Details
Entity Name
LINCOLN MEDICAL & MENTAL HEALTH CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330080
Entity Address
234 EAST 149TH ST
BRONX, NY 10451
Medicare Provider Number
330080
Participating Start Date
12/1/1992
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
NISAR PHARMACY INC
Pharmacy Address
253B E 149TH ST
BRONX, NY 10451-1865
Pharmacy Comments
Contract Details
Approval Date
4/3/2013
Contract Begin Date
4/3/2013
Carve-In Effective Date
Contract Comments
04/03/2013 - public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
10/23/2015
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
Ibrahim Khan, Owner
(718) 402-9104
Signed By Date
3/26/2013
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