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TOTAL CARE RX, INC.
DSH330127 JACOBI MEDICAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
JACOBI MEDICAL CENTER (NYCHHC)
Subdivision Name
FORMERLY BRONX MUNICIPAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH330127
Entity Address
1400 PELHAM PKWY SOUTH
BRONX, NY 10461
Medicare Provider Number
330127
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
TOTAL CARE RX, INC.
Pharmacy Address
WORLD'S FAIR PHARMACY
22310 UNION TPKE
OAKLAND GARDENS, NY 11364-3645
Pharmacy Comments
Contract Details
Approval Date
1/16/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
TOTAL CARE RX INC.
Robert Hopkins, President & Vice President
(718) 358-1300 Ext: 557
Signed By Date
1/16/2018
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