Contract Pharmacy Details

RXD MEDICATION SERVICES
STD19123 Bebashi - Transition to Hope

Covered Entity Details

Entity Name

Bebashi - Transition to Hope

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD19123

Entity Address

1235 Spring Garden Street
Philadelphia, PA 19123

Grant Number

6 NU62PS924728-03-04

Participating Start Date

1/1/2016

Last Recertification Date

6/4/2024

Pharmacy Details

Pharmacy Name

RXD MEDICATION SERVICES

Pharmacy Address

1335 W TABOR RD
PHILADELPHIA, PA 19141

Pharmacy Comments

Contract Details

Approval Date

7/13/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gary Bell, Executive Director
(215) 769-3561

Contract Pharmacy Representative

RXD Medication Services
Chuck Tallam, Chief Executive Officer
(215) 927-6700

Signed By Date

7/13/2018

340B Drug Pricing Program Database