340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BRIOVARX OF MAINE INC
DSH330196 NYC Health + Hospitals/South Brooklyn Health
Print
Covered Entity Details
Entity Name
NYC Health + Hospitals/South Brooklyn Health
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330196
Entity Address
2601 OCEAN PARKWAY
BROOKLYN, NY 11235
Medicare Provider Number
330196
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
BRIOVARX OF MAINE INC
Pharmacy Address
DBA BRIOVARX
53 DARLING AVE
SOUTH PORTLAND, ME 04106
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Briova Rx
Joe Iovino, Manager
(412) 445-4495
Signed By Date
1/11/2018
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