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PHILADELPHIA PHARMACY
CH031839C Esperanza Health Center, Inc.
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Covered Entity Details
Entity Name
Esperanza Health Center, Inc.
Subdivision Name
Esperanza Health Center
Type
HRSA-Funded Health Center
340B ID
CH031839C
Entity Address
4417 N 6th St
Philadelphia, PA 19140-2319
Grant Number
H80CS06644
Participating Start Date
10/1/2011
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PHILADELPHIA PHARMACY
Pharmacy Address
101 E LEHIGH AVENUE
PHILADELPHIA, PA 19125
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
Juan Perez, COO
(215) 807-8616
Contract Pharmacy Representative
Philadelphia Pharmacy
Richard Ost, President
(215) 425-2800
Signed By Date
7/13/2018
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