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904 PROSPECT PHARMACY INC
STD331381 Community Rightful Center, Inc.
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Covered Entity Details
Entity Name
Community Rightful Center, Inc.
Subdivision Name
Prevention, Education, Testing, Treatment and Case Management
Type
Sexually Transmitted Diseases
340B ID
STD331381
Entity Address
9526 NE 2 Ave #202D
Suite 202D
Miami Shores, FL 33138
Grant Number
NU62PS924532
Participating Start Date
11/26/2019
Last Recertification Date
5/30/2025
Pharmacy Details
Pharmacy Name
904 PROSPECT PHARMACY INC
Pharmacy Address
D/B/A BOCA PHARMACY
904 PROSPECT AVE
BRONX, NY 10459-3929
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Roseline Lous XVI, CEO/ director
(305) 754-5701
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
7/15/2020
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