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PARK PLAZA PHARMA INC
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
PARK PLAZA PHARMA INC
Pharmacy Address
DBA: PARK PLAZA PHARMACY
1773 UNIVERSITY AVENUE
BRONX, NY 10453-6961
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
Contacts
Covered Entity Signing Official
Peter Grisafi, Senior Vice President & COO
(212) 633-0800 Ext: 1225
Contract Pharmacy Representative
Park Plaza Pharma Inc.
Amish Patel, Pharmacist and Owner
(718) 583-5900
Signed By Date
9/17/2012
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