Contract Pharmacy Details

SOMERSET PHARMACY LLC
RWI191331 Congreso de Latinos Unidos, Inc.

Covered Entity Details

Entity Name

Congreso de Latinos Unidos, Inc.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI191331

Entity Address

216 West Somerset Street
Philadelphia, PA 19133

Grant Number

H89HA00013

Participating Start Date

4/1/2016

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

SOMERSET PHARMACY LLC

Pharmacy Address

216 W SOMERSET ST
PHILADELPHIA, PA 19133-3534

Pharmacy Comments

Contract Details

Approval Date

4/8/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Brendan Conlin, Mr.
(267) 243-9710

Contract Pharmacy Representative

Philadelphia Pharmacy
Richard Ost, President
(215) 425-2800

Signed By Date

4/8/2021

340B Drug Pricing Program Database