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GREATER PHILADELPHIA PHARMACY
CH03320A GREATER PHILADELPHIA HEALTH ACTION, INCORPORATED
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Covered Entity Details
Entity Name
GREATER PHILADELPHIA HEALTH ACTION, INCORPORATED
Subdivision Name
Carl Moore Health Center
Type
HRSA-Funded Health Center
340B ID
CH03320A
Entity Address
1401 S 31 ST
Philadelphia, PA 19146
Grant Number
H80CS00708
Participating Start Date
10/1/2003
Last Recertification Date
1/28/2020
Entity Termination Date
10/1/2020
Pharmacy Details
Pharmacy Name
GREATER PHILADELPHIA PHARMACY
Pharmacy Address
GREATER PHILADELPHIA PHARMACY
1401 S 31ST. ST.
PHILADELPHIA, PA 19146-1912
Pharmacy Comments
Contract Details
Approval Date
10/8/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Brian Clark, CEO
(215) 925-2400 Ext: 1060
Contract Pharmacy Representative
SYNERGY RX EXPRESS PHARMACY
Emmanuel Nyarko, Director of Pharmacy
(302) 323-1687
Signed By Date
10/8/2019
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