Contract Pharmacy Details

ALTRUIX
CH030480 B-K HEALTH CENTER, INC.

Covered Entity Details

Entity Name

B-K HEALTH CENTER, INC.

Subdivision Name

NEPA Community Health Care-Susquehanna Site

Type

HRSA-Funded Health Center

340B ID

CH030480

Entity Address

155 Erie Blvd
Susquehanna, PA 18847-2791

Grant Number

H80CS00420

Participating Start Date

7/1/2005

Last Recertification Date

2/19/2020

Entity Termination Date

7/1/2020

Pharmacy Details

Pharmacy Name

ALTRUIX

Pharmacy Address

3800 HORIZON BLVD STE 103
TREVOSE, PA 19053

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

7/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Mary W. Wetherall, CEO
(570) 278-5161

Contract Pharmacy Representative

BANKS APOTHECARY
LISA CARROLL, ADMINISTRATOR
(215) 494-9403

Signed By Date

7/17/2018