340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ELMHURST PHARMACY & HOME INFUSION INC.
DSH330128 ELMHURST HOSPITAL CENTER (NYCHHC)
Print
Covered Entity Details
Entity Name
ELMHURST HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330128
Entity Address
79-01 BROADWAY
ELMHURST, NY 11373
Medicare Provider Number
330128
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
ELMHURST PHARMACY & HOME INFUSION INC.
Pharmacy Address
8106 BAXTER AVE
ELMHURST, NY 11373
Pharmacy Comments
Contract Details
Approval Date
1/4/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/10/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Elmhurst Pharmacy and Home Infusion
Wanas Khalil, POC
(718) 507-2299
Signed By Date
1/4/2018
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