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866 EAST TREMONT PHARMACY LLC
RWI19146 URBAN HEALTH SOLUTIONS INC.
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Covered Entity Details
Entity Name
URBAN HEALTH SOLUTIONS INC.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19146
Entity Address
1408 S BROAD STREET
FIRST FLOOR
PHILADELPHIA, PA 19146
Grant Number
H89HA00013
Participating Start Date
4/1/2011
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
866 EAST TREMONT PHARMACY LLC
Pharmacy Address
BOCA PHARMACY
864B E TREMONT AVE
BRONX, NY 10460
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
Yvonne Jones, Project Director
(215) 755-6462 Ext: 139
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
7/15/2021
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