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NUCARE PHARMACY INC.
DSH330199 METROPOLITAN HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
METROPOLITAN HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330199
Entity Address
1901 FIRST AVE.
NEW YORK, NY 10029
Medicare Provider Number
330199
Participating Start Date
7/1/1993
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
NUCARE PHARMACY INC.
Pharmacy Address
NUCARE PHARMACY & SURGICAL
1789 1ST AVE
NEW YORK, NY 10128
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
3/30/2018
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
Kenny Wivietsky, Owner
(212) 426-9300
Signed By Date
3/26/2013
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