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GREATER PHILADELPHIA PHARMACY
CH031260 SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.
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Covered Entity Details
Entity Name
SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.
Subdivision Name
DBA HENRIETTA JOHNSON MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH031260
Entity Address
601 NEW CASTLE AVENUE
WILMINGTON, DE 19801
Grant Number
H80CS00385
Participating Start Date
10/13/2005
Last Recertification Date
2/13/2025
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
7/14/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shay Scott, CEO
(302) 655-6187 Ext: 230
Contract Pharmacy Representative
APOVIS PHARMACY SERVICES
Emmanuel Nyarko, CEO
(267) 901-0000
Signed By Date
7/14/2020
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