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NANTASKET PHARMACY INC
CH011640 MANET COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
MANET COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
MANET COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011640
Entity Address
110 W Squantum St
Quincy, MA 02171-2122
Grant Number
H80CS00453
Participating Start Date
4/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
NANTASKET PHARMACY INC
Pharmacy Address
480 NANTASKET AVE
HULL, MA 02045
Pharmacy Comments
Contract Details
Approval Date
10/13/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/29/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gail Covelluzzi, CFO
(617) 690-6953
Contract Pharmacy Representative
Rocky Tenaglia, President
(781) 925-1270
Signed By Date
10/13/2016
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