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BETHLEHEM PHARMACY RX INC
FQHCLA410 Star Community Health, Inc.
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Covered Entity Details
Entity Name
Star Community Health, Inc.
Subdivision Name
Star Community Health Administration
Type
Health Center Program Look-Alike
340B ID
FQHCLA410
Entity Address
520 E Broad St Ste 108
Bethlehem, PA 18018-6330
Grant Number
LALCS33897
Participating Start Date
10/1/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BETHLEHEM PHARMACY RX INC
Pharmacy Address
817 E 4TH ST APT 1
FL 1
BETHLEHEM, PA 18015
Pharmacy Comments
Contract Details
Approval Date
10/14/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christine Davco, CEO
(610) 841-6180
Contract Pharmacy Representative
Bethlehem Pharmacy Rx, Inc
Sridevi Bavirisetty, Vice-President
(609) 915-4999
Signed By Date
10/14/2020
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