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COORDINATED CARE NETWORK PHARMACY
RWII18603B Caring Communities For AIDS, Inc.
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Covered Entity Details
Entity Name
Caring Communities For AIDS, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII18603B
Entity Address
20 North Laurel Street
Suite 2B
Hazleton, PA 18201
Grant Number
X07HA00021
Participating Start Date
7/1/2020
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
249 S 13TH ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
5/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Kupchik, Chief Executive Officer
(570) 899-1298
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
4/13/2020
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