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2355 2ND AVE NYS LLC
CH020130 HERITAGE HEALTH AND HOUSING, INC.
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Covered Entity Details
Entity Name
HERITAGE HEALTH AND HOUSING, INC.
Subdivision Name
HERITAGE HEALTH AND HOUSING, INC.
Type
HRSA-Funded Health Center
340B ID
CH020130
Entity Address
1727 Amsterdam Ave
New York, NY 10031-4611
Grant Number
H80CS11285
Participating Start Date
1/1/2002
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
2355 2ND AVE NYS LLC
Pharmacy Address
2355 2ND AVE
NEW YORK, NY 10035
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
5/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Douglas B Blomberg, Chief Financial Officer
(212) 862-0054
Contract Pharmacy Representative
Branac Inc.
Elena Ivanova, COO
(212) 249-8202
Signed By Date
4/14/2020
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