Contract Pharmacy Details

AVS PHARMACY
CHC28355-00 UNION COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

UNION COMMUNITY HEALTH CENTER, INC.

Subdivision Name

Union Community Health Center #1

Type

HRSA-Funded Health Center

340B ID

CHC28355-00

Entity Address

260 E 188th St
Bronx, NY 10458-5302

Grant Number

H80CS28355

Participating Start Date

4/1/2016

Last Recertification Date

2/27/2025

Pharmacy Details

Pharmacy Name

AVS PHARMACY

Pharmacy Address

D/B/A LEROY PHARMACY
314 E 204TH ST
BRONX, NY 10467

Pharmacy Comments

Contract Details

Approval Date

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/30/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Anne Spellman, Chief Operating Officer
(718) 618-8236

Contract Pharmacy Representative

Pharmacy
Jay Dhaduk, Supervising Pharmist
(718) 882-5614

Signed By Date

1/15/2020

340B Drug Pricing Program Database