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BELL PHARMACY
FQHCLA365 OSBORN FAMILY HEALTH CENTER, INC., THE
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Covered Entity Details
Entity Name
OSBORN FAMILY HEALTH CENTER, INC., THE
Subdivision Name
Osborn Family Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA365
Entity Address
1601 Haddon Avenue
Camden, NJ 08103-3109
Grant Number
LALCS31541
Participating Start Date
4/1/2018
Last Recertification Date
1/28/2020
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
BELL PHARMACY
Pharmacy Address
1201 HADDON AVE
CAMDEN, NJ 08103-3105
Pharmacy Comments
Contract Details
Approval Date
4/25/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Shawne Cuilla, Executive Director/CEO
(856) 757-3706
Contract Pharmacy Representative
Bell Pharmacy
Anthony Minniti, Pharmacist
(856) 963-4742
Signed By Date
4/25/2018
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