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SAFEWAY PHARMACY INC
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS
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Covered Entity Details
Entity Name
NEW YORK CITY HEALTH AND HOSPITALS
Subdivision Name
Cumberland Diagnostic and Treatment Center
Type
HRSA-Funded Health Center
340B ID
CHC29018-00
Entity Address
100 N Portland Ave
Brooklyn, NY 11205-2005
Grant Number
H80CS29018
Participating Start Date
4/1/2016
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
SAFEWAY PHARMACY INC
Pharmacy Address
493 E 138 STREET
BRONX, NY 10454
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Safe Way
Sagnia Balbuena, Owner
(718) 401-8308
Signed By Date
10/15/2018
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