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JOLIN RX INC.
HV00746 Promesa, Inc.
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Covered Entity Details
Entity Name
Promesa, Inc.
Subdivision Name
Promesa, Inc.
Type
Ryan White Part C
340B ID
HV00746
Entity Address
1776 Clay Avenue
Bronx, NY 10457
Grant Number
H76HA00746
Participating Start Date
7/1/2018
Last Recertification Date
2/26/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
JOLIN RX INC.
Pharmacy Address
DBA: JOLIN PHARMACY
1870 GRAND CONCOURSE
BRONX, NY 10457-5473
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Raul Russi, Chief Executive Officer
(347) 649-3037
Contract Pharmacy Representative
Jolin Rx Inc
Rajesh Mathew, Pharmacist/Owner
(718) 294-5588
Signed By Date
1/15/2019
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