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GREATER PHILADELPHIA PHARMACY
CH030130 PARK WEST HEALTH SYSTEMS INCORPORATED
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Covered Entity Details
Entity Name
PARK WEST HEALTH SYSTEMS INCORPORATED
Subdivision Name
PARK WEST MEDICAL CENTER - BELVEDERE
Type
HRSA-Funded Health Center
340B ID
CH030130
Entity Address
3319 W Belvedere Ave
Baltimore, MD 21215-5143
Grant Number
H80CS00067
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
GREATER PHILADELPHIA PHARMACY
Pharmacy Address
UNIVERSAL PHARMACY SERVICES
432 N 6TH. ST.
PHILADELPHIA, PA 19123-4004
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALLEN J. BENNETT, PRESIDENT & CEO
(410) 542-7800 Ext: 7501
Contract Pharmacy Representative
APOVIA
EMMANUEL NYARKO, CEO
(267) 901-0000
Signed By Date
7/6/2020
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