Covered Entity Details

Bebashi Transition to Hope (Pending) - information as of 4/25/2025 12:00:28 AM

Main Details

Name

Bebashi Transition to Hope

Subdivision Name

Type

Ryan White Part A

340B ID

Grant Number

H89HA00013

Additional Details

Current Program Status

Pending

Registration Date

4/7/2025

Participating Start Date

Participating Approval Date

Last Recertification Date

Time Period the Assistance was Received

3/1/2025 - 2/28/2026

Contacts

Authorizing Official

Bebashi
Sebrina Tate, Director of Programs and Administration
(215) 769-3561 Ext: 2157693561

Primary Contact

Bebashi-Transition to Hope
Nafisah Houston, Director of Programs
(215) 769-3561 Ext: 129

Addresses

Street Address

4101 Woodland Avenue
Philadelphia, PA 19104

Billing Address

Bebashi Transition to Hope
4100 Chester Avenue
Suite 300
Philadelphia, PA 19104

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
No records to display.

History

Section	Field	Action	Activity	Value After	Timestamp
Addresses	Main Address	Insert	New Registration	4101 Woodland Avenue Philadelphia, PA 19104	4/7/2025 10:37 AM
Addresses	Billing Address	Insert	New Registration	Bebashi Transition to Hope 4100 Chester Avenue Suite 300 Philadelphia, PA 19104	4/7/2025 10:37 AM
Contacts	Authorizing Official	Insert	New Registration	Tate, Sebrina Director of Programs and Administration Bebashi 2157693561-2157693561	4/7/2025 10:37 AM
Contacts	Primary Contact	Insert	New Registration	Houston, Nafisah Director of Programs Bebashi-Transition to Hope 2157693561-129	4/7/2025 10:37 AM
Details	Assistance Received From Date	Insert	New Registration	3/1/2025 12:00:00 AM	4/7/2025 10:37 AM
Details	Assistance Received To Date	Insert	New Registration	2/28/2026 12:00:00 AM	4/7/2025 10:37 AM
Details	Last Recertification Date	Insert	New Registration		4/7/2025 10:37 AM
Details	Grant Number	Insert	New Registration	H89HA00013	4/7/2025 10:37 AM
Details	340B ID	Insert	New Registration		4/7/2025 10:37 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration		4/7/2025 10:37 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration		4/7/2025 10:37 AM
Details	Medicare Provider Number	Insert	New Registration		4/7/2025 10:37 AM
Details	Entity Name	Insert	New Registration	Bebashi Transition to Hope	4/7/2025 10:37 AM
Details	NOFO Number	Insert	New Registration		4/7/2025 10:37 AM
Details	Program Code	Insert	New Registration	RWI	4/7/2025 10:37 AM
Details	Entity Subname	Insert	New Registration		4/7/2025 10:37 AM
Dates	Participating Approval Date	Insert	New Registration		4/7/2025 10:37 AM
Details	State	Insert	New Registration	Pending	4/7/2025 10:37 AM
Dates	Registration Date	Insert	New Registration	4/7/2025 10:37:33 AM	4/7/2025 10:37 AM
Dates	Signed By Date	Insert	New Registration		4/7/2025 10:37 AM
Dates	Start Date	Insert	New Registration		4/7/2025 10:37 AM
Terminations	Termination Comments	Insert	New Registration		4/7/2025 10:37 AM
Terminations	Termination Date	Insert	New Registration		4/7/2025 10:37 AM
Terminations	Termination Effective Date	Insert	New Registration		4/7/2025 10:37 AM
Terminations	Termination Reason	Insert	New Registration		4/7/2025 10:37 AM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History