340B Drug Pricing Program Database

Pharmacy Name

BLACKSTONE HEALTH MART PHARMACY

Pharmacy Address

GARY S KISHFY
465 LONSDALE AVE SUITE B
PAWTUCKET, RI 02860-0286

Pharmacy Comments

Approval Date

10/20/2011

Contract Begin Date

11/14/2008

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/10/2016
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official


Contract Pharmacy Representative

Signed By Date

11/7/2008