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MEDLY PHARMACY
CH031670 PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
Public Health Management Corporation
Type
HRSA-Funded Health Center
340B ID
CH031670
Entity Address
Centre Square East
1500 Market Street
Philadelphia, PA 19102-2100
Grant Number
H80CS00016
Participating Start Date
7/1/2004
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
MEDLY PHARMACY
Pharmacy Address
1222 WALNUT ST
PHILADELPHIA, PA 19107-5466
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Richard Cohen, President and CEO
(215) 985-2501
Contract Pharmacy Representative
Medly Pharmacy
Nate Coney, VP
(609) 992-9692
Signed By Date
4/15/2021
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