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COUZINS ENTERPRISES DBA PATRIOT PHARMACY
CH03378F Quality Community Health Care, Inc.
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Covered Entity Details
Entity Name
Quality Community Health Care, Inc.
Subdivision Name
COOKE FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03378F
Entity Address
1300 W Louden St
Philadelphia, PA 19141-2603
Grant Number
H80CS00687
Participating Start Date
10/1/2021
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
COUZINS ENTERPRISES DBA PATRIOT PHARMACY
Pharmacy Address
2951 N 22ND ST
PHILADELPHIA, PA 19132-1505
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARCELLA LINGHAM, CEO
(215) 227-0300 Ext: 7308
Contract Pharmacy Representative
Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763
Signed By Date
7/14/2021
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