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EDDYSTONE COMMUNITY PHARMACY
CH033930 CHESPENN HEALTH SERVICES
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Covered Entity Details
Entity Name
CHESPENN HEALTH SERVICES
Subdivision Name
CHESPENN HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH033930
Entity Address
1510 Chester Pike, Suite 200
Eddystone, PA 19022
Grant Number
H80CS00738
Participating Start Date
1/1/2003
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
EDDYSTONE COMMUNITY PHARMACY
Pharmacy Address
AIDS CARE GROUP
1207B CHESTER PIKE
EDDYSTONE, PA 19022
Pharmacy Comments
Contract Details
Approval Date
7/20/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/10/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael G. Lucas, CEO and President
(610) 485-3800 Ext: 630
Contract Pharmacy Representative
Fungisai Nota, Owner
(484) 480-3341
Signed By Date
7/20/2015
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