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SBV PHARMACY CORP
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
SBV PHARMACY CORP
Pharmacy Address
DBA: MARCIA PHARMACY
217 E 106TH ST
NEW YORK, NY 10029
Pharmacy Comments
Contract Details
Approval Date
4/16/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Antonio Martin, Ececutive Vice President & Chief Operating Officier
(212) 788-3479
Contract Pharmacy Representative
Vijay Vasireddy, Owner
(212) 534-1939
Signed By Date
4/16/2014
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