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S J S PHARMACY
CH02371G INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
WALTON FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH02371G
Entity Address
1894 Walton Ave
Bronx, NY 10453-6018
Grant Number
H80CS00768
Participating Start Date
1/1/2002
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
S J S PHARMACY
Pharmacy Address
105-107 E. BURNSIDE AVE.
BRONX, NY 10453
Pharmacy Comments
Contract Details
Approval Date
11/6/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
11/06/2012 public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
9/30/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Peter Grisafi, Senior Vice President & COO
(212) 633-0800 Ext: 1225
Contract Pharmacy Representative
Patrick Daddino, Pharmacist and Owner
(718) 933-1222
Signed By Date
9/19/2012
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