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PHARMACY PLUS SURGICAL SUPPLIES INC.
CH02360G URBAN HEALTH PLAN, INC.
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Covered Entity Details
Entity Name
URBAN HEALTH PLAN, INC.
Subdivision Name
PS 333/PS 335
Type
HRSA-Funded Health Center
340B ID
CH02360G
Entity Address
888 Rev James A Polite Ave
Bronx, NY 10459-4107
Grant Number
H80CS00368
Participating Start Date
10/1/2014
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
PHARMACY PLUS SURGICAL SUPPLIES INC.
Pharmacy Address
1770D WESTCHESTER AVE
BRONX, NY 10472-3022
Pharmacy Comments
Contract Details
Approval Date
10/28/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paloma Hernandez, President and CEO
(718) 589-2440 Ext: 4219
Contract Pharmacy Representative
Pharmacy Plus Surgical Supplies Inc.
Hassan Rizvi, President
(718) 430-0911
Signed By Date
10/28/2019
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