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CASA DE VIDA INC.
CH02161G MORRIS HEIGHTS HEALTH CENTER INC
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Covered Entity Details
Entity Name
MORRIS HEIGHTS HEALTH CENTER INC
Subdivision Name
SBHC CES 126
Type
HRSA-Funded Health Center
340B ID
CH02161G
Entity Address
175 W 166TH ST
BRONX, NY 10452-4500
Grant Number
H80CS00472
Participating Start Date
1/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
CASA DE VIDA INC.
Pharmacy Address
52 W BURNSIDE AVE
BRONX, NY 10453
Pharmacy Comments
Contract Details
Approval Date
8/1/2017
Contract Begin Date
10/1/2017
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
Casa De Vida Inc.
Dinesh Desai, Owner
(201) 675-0353
Signed By Date
8/1/2017
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