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PRXP OF NEW YORK LLC
CH040310 BORINQUEN HEALTH CARE CENTER INC
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Covered Entity Details
Entity Name
BORINQUEN HEALTH CARE CENTER INC
Subdivision Name
BMC Emilio Lopez Pavilion (Main Site)
Type
HRSA-Funded Health Center
340B ID
CH040310
Entity Address
3601 Federal Hwy
Miami, FL 33137-3795
Grant Number
H80CS00618
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PRXP OF NEW YORK LLC
Pharmacy Address
DBA BROADWAY FAMILY PHARMACY
601 AMSTERDAM AVE
NEW YORK, NY 10024
Pharmacy Comments
Contract Details
Approval Date
10/9/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/21/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Carl Velez, CEO
(305) 788-5055
Contract Pharmacy Representative
Physicians Rx Pharmacy of Clinton
Chris Wakefield, Manager
(412) 357-5163
Signed By Date
10/9/2019
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