Covered Entity Details

STD19130 Prevention Point Philadelphia (Active) - information as of 5/29/2025 1:54:26 AM

Main Details

Name

Prevention Point Philadelphia

Subdivision Name

Philly Home

Type

Sexually Transmitted Diseases

340B ID

STD19130

Grant Number

NH25PS240047

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

Direct Funding (dollars received from CDC or an intermediate organization)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.

8/1/2024

Additional Details

Current Program Status

Active

Registration Date

7/12/2024

Participating Start Date

10/1/2024

Participating Approval Date

8/29/2024

Last Recertification Date

5/19/2025

Notice of Funding Opportunity (NOFO) Number

PS24-0047

Contacts

Authorizing Official

Prevention Point Philadelphia
Silvana Mazzella, Lead Executive Officer
(267) 975-5419

Primary Contact

Prevention Point Philadelphia
Anne Kelly, Medical Services Sustainability Manager
(215) 589-5555

Addresses

Street Address

2100 West Girard Avenue
Philadelphia, PA 19130

Billing Address

Prevention Point Philadelphia
PO Box 60990
Philadelphia, PA 19133

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	SUNRAY DRUGS KENSINGTON & ALLEGHENY	825 E ALLEGHENY AVE		PHILADELPHIA	PA	19134	10/13/2024	01/01/2025			01/01/2025
Contract Detail	SUNRAY DRUGS SPECIALTY	142 S 52ND ST	SUITE 201	PHILADELPHIA	PA	19139	10/13/2024	01/01/2025			01/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		5/19/2025 11:38:16 AM	5/19/2025 11:38 AM
Contacts	Authorizing Official	Update	Profile Change Request	Mazzella, Silvana Interim Lead Director Prevention Point Philadelphia 2679755419	Mazzella, Silvana Lead Executive Officer Prevention Point Philadelphia 2679755419	3/5/2025 2:22 PM
Contacts	Signed By	Update	Profile Change Request	Mazzella, Silvana Interim Lead Director Prevention Point Philadelphia 2679755419	Mazzella, Silvana Lead Executive Officer Prevention Point Philadelphia 2679755419	3/5/2025 2:22 PM
Details	State	Update		Approved	Active	10/1/2024 12:01 AM
Addresses	Main Address	Insert	New Registration		2100 West Girard Avenue Philadelphia, PA 19130	8/29/2024 9:51 AM
Addresses	Billing Address	Insert	New Registration		Prevention Point Philadelphia PO Box 60990 Philadelphia, PA 19133	8/29/2024 9:51 AM
Contacts	Signed By	Insert	New Registration		Mazzella, Silvana Interim Lead Director Prevention Point Philadelphia 2679755419	8/29/2024 9:51 AM
Details	340B ID	Update	New Registration		STD19130	8/29/2024 9:51 AM
Dates	Participating Approval Date	Update	New Registration		8/29/2024 9:51:13 AM	8/29/2024 9:51 AM
Details	State	Update	New Registration	Pending	Approved	8/29/2024 9:51 AM
Dates	Signed By Date	Update	New Registration		8/15/2024 12:29:25 PM	8/29/2024 9:51 AM
Dates	Start Date	Update	New Registration		10/1/2024 12:00:00 AM	8/29/2024 9:51 AM
Addresses	Main Address	Insert	New Registration		2100 West Girard Avenue Philadelphia, PA 19130	8/15/2024 12:29 PM
Addresses	Billing Address	Insert	New Registration		Prevention Point Philadelphia PO Box 60990 Philadelphia, PA 19133	8/15/2024 12:29 PM
Details	NOFO Number	Update	New Registration	CDC-RFA-PS-24-00470101SUPP24	PS24-0047	8/15/2024 12:29 PM
Addresses	Main Address	Insert	New Registration		2100 West Girard Avenue Philadelphia, PA 19130	8/12/2024 3:14 PM
Addresses	Billing Address	Insert	New Registration		Prevention Point Philadelphia PO Box 60990 Philadelphia, PA 19133	8/12/2024 3:14 PM
Details	Nature of Support: Support Received From Date	Update	New Registration	7/12/2024 12:00:00 AM	8/1/2024 12:00:00 AM	8/12/2024 3:14 PM
Details	Grant Number	Update	New Registration	PS18-1802	NH25PS240047	8/12/2024 3:14 PM
Details	NOFO Number	Update	New Registration	NU62PS924545	CDC-RFA-PS-24-00470101SUPP24	8/12/2024 3:14 PM
Addresses	Main Address	Insert	New Registration		2100 West Girard Avenue Philadelphia, PA 19130	7/12/2024 3:54 PM
Addresses	Billing Address	Insert	New Registration		Prevention Point Philadelphia PO Box 60990 Philadelphia, PA 19133	7/12/2024 3:54 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration			7/12/2024 3:54 PM
Details	Nature Of Support	Insert	New Registration		Direct Funding (dollars received from CDC or an intermediate organization)	7/12/2024 3:54 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		7/12/2024 12:00:00 AM	7/12/2024 3:54 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration			7/12/2024 3:54 PM
Contacts	Authorizing Official	Insert	New Registration		Mazzella, Silvana Interim Lead Director Prevention Point Philadelphia 2679755419	7/12/2024 3:54 PM
Contacts	Primary Contact	Insert	New Registration		Kelly, Anne Medical Services Sustainability Manager Prevention Point Philadelphia 2155895555	7/12/2024 3:54 PM
Details	Assistance Received From Date	Insert	New Registration			7/12/2024 3:54 PM
Details	Assistance Received To Date	Insert	New Registration			7/12/2024 3:54 PM
Details	Last Recertification Date	Insert	New Registration			7/12/2024 3:54 PM
Details	Grant Number	Insert	New Registration		PS18-1802	7/12/2024 3:54 PM
Details	340B ID	Insert	New Registration			7/12/2024 3:54 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/12/2024 3:54 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/12/2024 3:54 PM
Details	Medicare Provider Number	Insert	New Registration			7/12/2024 3:54 PM
Details	Entity Name	Insert	New Registration		Prevention Point Philadelphia	7/12/2024 3:54 PM
Details	NOFO Number	Insert	New Registration		NU62PS924545	7/12/2024 3:54 PM
Details	Program Code	Insert	New Registration		STD	7/12/2024 3:54 PM
Details	Entity Subname	Insert	New Registration		Philly Home	7/12/2024 3:54 PM
Dates	Participating Approval Date	Insert	New Registration			7/12/2024 3:54 PM
Details	State	Insert	New Registration		Pending	7/12/2024 3:54 PM
Dates	Registration Date	Insert	New Registration		7/12/2024 3:54:16 PM	7/12/2024 3:54 PM
Dates	Signed By Date	Insert	New Registration			7/12/2024 3:54 PM
Dates	Start Date	Insert	New Registration			7/12/2024 3:54 PM
Terminations	Termination Comments	Insert	New Registration			7/12/2024 3:54 PM
Terminations	Termination Date	Insert	New Registration			7/12/2024 3:54 PM
Terminations	Termination Effective Date	Insert	New Registration			7/12/2024 3:54 PM
Terminations	Termination Reason	Insert	New Registration			7/12/2024 3:54 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History