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BOBS PHARMACY LLC
CHC33656-01 Upstate Family Health Center, Inc.
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Covered Entity Details
Entity Name
Upstate Family Health Center, Inc.
Subdivision Name
Upstate Family Health Center, Inc. Kernan SBHC
Type
HRSA-Funded Health Center
340B ID
CHC33656-01
Entity Address
929 York St
Utica, NY 13502-3929
Grant Number
H80CS33656
Participating Start Date
7/1/2020
Last Recertification Date
2/2/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
BOBS PHARMACY LLC
Pharmacy Address
D/B/A GARROS DRUGS
430 BLEECKER ST
UTICA, NY 13501
Pharmacy Comments
Contract Details
Approval Date
4/16/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
John Milligan, Chief Executive Officer
(315) 624-9470 Ext: 260
Contract Pharmacy Representative
Bob's Pharmacy
Mallika Kopalle, Owner
(315) 732-6915
Signed By Date
4/16/2020
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