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AHSSHC
CH011280 DIMOCK COMM HEALTH CENTER
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Covered Entity Details
Entity Name
DIMOCK COMM HEALTH CENTER
Subdivision Name
DIMOCK COMM HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH011280
Entity Address
45 DIMOCK ST
ROXBURY, MA 02119
Grant Number
H80CS00151
Participating Start Date
7/1/2003
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
AHSSHC
Pharmacy Address
EXPEDIEN RX PHARMACY
5050 WESLEY RD STE 120
APOPKA, FL 32712
Pharmacy Comments
Contract Details
Approval Date
7/20/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Myechia minter-Jordan, CEO
(617) 442-8800 Ext: 1201
Contract Pharmacy Representative
Agape
Trenia Yielding, Executive Director
(407) 357-2601
Signed By Date
7/20/2017
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