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COORDINATED CARE NETWORK PHARMACY
CH03290A DELAWARE VALLEY COMMUNITY HEALTH, INC.
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Covered Entity Details
Entity Name
DELAWARE VALLEY COMMUNITY HEALTH, INC.
Subdivision Name
MARIA DE LOS SANTOS HEALTH CTR
Type
HRSA-Funded Health Center
340B ID
CH03290A
Entity Address
401-55 WEST ALLEGHENY AVENUE
PHILADELPHIA, PA 19133-3639
Grant Number
H80CS00833
Participating Start Date
7/1/2007
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
249 S 13TH ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott McNeal, DO, President and CEO
(215) 684-5344
Contract Pharmacy Representative
CCN AMERICA LP
Thomas J. Pollack, Vice President and CFO
(412) 349-6303
Signed By Date
10/14/2019
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