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GREATER PHILADELPHIA PHARMACY
CH03320G GREATER PHILADELPHIA HEALTH ACTION, INCORPORATED
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Covered Entity Details
Entity Name
GREATER PHILADELPHIA HEALTH ACTION, INCORPORATED
Subdivision Name
AL-ASSIST BEHAVIORAL HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH03320G
Entity Address
1401 S 4th St
Philadelphia, PA 19147-5907
Grant Number
H80CS00708
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
GREATER PHILADELPHIA PHARMACY
Pharmacy Address
1401 S 4TH ST
PHILADELPHIA, PA 19147-5948
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
11/22/2024
Ownership change
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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