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MAGELLAN RX PHARMACY, LLC.
CH021630 COMMUNITY HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
COMMUNITY HEALTHCARE NETWORK
Subdivision Name
COMMUNITY HEALTHCARE NETWORK
Type
HRSA-Funded Health Center
340B ID
CH021630
Entity Address
60 MADSION AVE
5TH FLOOR
NEW YORK, NY 10010
Grant Number
H80CS00597
Participating Start Date
10/1/2001
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
MAGELLAN RX PHARMACY, LLC.
Pharmacy Address
31-75 23RD STREET
SUITE 410
ASTORIA, NY 11106
Pharmacy Comments
Contract Details
Approval Date
7/15/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/7/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alan Wengrofsky, CFO
(212) 545-2481
Contract Pharmacy Representative
Eddie Wong, Pharmacist
(407) 858-6206
Signed By Date
7/15/2016
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