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ROCKAWAY FAMILY PHARMACY CORP
CH02360AB URBAN HEALTH PLAN, INC.
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Covered Entity Details
Entity Name
URBAN HEALTH PLAN, INC.
Subdivision Name
Archcare - St. Vincent de Paul Residence
Type
HRSA-Funded Health Center
340B ID
CH02360AB
Entity Address
900 Intervale Ave
Bronx, NY 10459-4240
Grant Number
H80CS00368
Participating Start Date
7/1/2019
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
ROCKAWAY FAMILY PHARMACY CORP
Pharmacy Address
D/B/A BOCA PHARMACY
872 HUNTS POINT AVE
BRONX, NY 10474
Pharmacy Comments
Contract Details
Approval Date
5/6/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paloma Hernandez, President and CEO
(718) 589-2440 Ext: 4219
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
4/19/2019
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