Contract Pharmacy Details

TOWN TOTAL HEALTH, LLC
RW4248550 The Albany Damien Center Inc.

Covered Entity Details

Entity Name

The Albany Damien Center Inc.

Subdivision Name

Type

Ryan White Part D

340B ID

RW4248550

Entity Address

728 Madison Ave
Suite 100
Albany, NY 12208-3302

Grant Number

H12HA24855

Participating Start Date

1/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

TOWN TOTAL HEALTH, LLC

Pharmacy Address

728 MADISON AVE.
SUITE B1
ALBANY, NY 12208-3302

Pharmacy Comments

Contract Details

Approval Date

1/14/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/8/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Perry Junjulas, Executive Director
(518) 449-7119 Ext: 102

Contract Pharmacy Representative

Meijer
Katy Diaz, Pharmacy Business Associate
(616) 791-3127

Signed By Date

1/14/2020

340B Drug Pricing Program Database