340B Drug Pricing Program Database
ELDER PHARMACY LLC
CH02360T URBAN HEALTH PLAN, INC. - information as of 4/28/2025 1:53:02 AM
Covered Entity Details
Entity Name
URBAN HEALTH PLAN, INC.
Subdivision Name
Urban Health Plan at Kips Bay Boys and Girls Club Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH02360T
Entity Address
1930 Randall Ave
Bronx, NY 10473-2608
Grant Number
H80CS00368
Participating Start Date
10/1/2015
Last Recertification Date
2/20/2023
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
ELDER PHARMACY LLC
Pharmacy Address
D/B/A LEROY PHARMACY
1527 WESTCHESTER AVE
BRONX, NY 10472-2908
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Paloma Hernandez, President and CEO
(718) 589-2440 Ext: 4219
Contract Pharmacy Representative
Elder Pharmacy, LLC.
Sanjiv Seth, CEO
(917) 670-9484
Signed By Date
7/17/2018
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