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PERSONIFILRX NEW ENGLAND, LLC
CHC29010-00 UPHAMS CORNER HEALTH COMMITTEE, INC.
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Covered Entity Details
Entity Name
UPHAMS CORNER HEALTH COMMITTEE, INC.
Subdivision Name
Upham's Corner Health Center
Type
HRSA-Funded Health Center
340B ID
CHC29010-00
Entity Address
415 Columbia Rd
Dorchester, MA 02125-2424
Grant Number
H80CS29010
Participating Start Date
1/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PERSONIFILRX NEW ENGLAND, LLC
Pharmacy Address
225 METRO CENTER BLVD BLDG 2
WARWICK, RI 02886-1783
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
Jagdeep Trivedi, CEO
(617) 287-8000 Ext: 8131
Contract Pharmacy Representative
PersonifilRx
Mike Gregoire, Pharmacist-in-Charge
(401) 593-1001
Signed By Date
7/14/2020
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