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75 BURNSIDE DRUG & SURGICAL
CH02161F MORRIS HEIGHTS HEALTH CENTER INC
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Covered Entity Details
Entity Name
MORRIS HEIGHTS HEALTH CENTER INC
Subdivision Name
MORRIS HEIGHTS HC @ Walton
Type
HRSA-Funded Health Center
340B ID
CH02161F
Entity Address
25 E 183rd St
Bronx, NY 10453-1242
Grant Number
H80CS00472
Participating Start Date
1/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
75 BURNSIDE DRUG & SURGICAL
Pharmacy Address
DBA: BURNSIDE PHARMACY
75 W BURNSIDE AVE
BRONX, NY 10453-4015
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
10/1/2018
Contract Comments
Contacts
Covered Entity Signing Official
Claudette Phipps, VP Planning and Development
(718) 483-1270 Ext: 2312
Contract Pharmacy Representative
Burnside Pharmacy
Varghese Abraham, Owner
(718) 731-8505
Signed By Date
4/17/2017
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