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COMMUNITY CARE RX INC.
CH021887U SUNSET PARK HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
SUNSET PARK HEALTH COUNCIL, INC.
Subdivision Name
Metro Community Health Centers - Staten island
Type
HRSA-Funded Health Center
340B ID
CH021887U
Entity Address
2324 Forest Avenue
Staten Island, NY 10303
Grant Number
H80CS07914
Participating Start Date
4/1/2016
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
COMMUNITY CARE RX INC.
Pharmacy Address
131 SUNNYSIDE BLVD STE 100
PLAINVIEW, NY 11803
Pharmacy Comments
Contract Details
Approval Date
4/7/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/16/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Larry K. McReynolds, Executive Director
(718) 630-7216
Contract Pharmacy Representative
Community Care Rx, Inc.
Nicholas Vartanian, Director of Corporate Development
(516) 418-8058 Ext: 101
Signed By Date
4/7/2020
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