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RL MT. VERNON PHARMACY INC
CH021500 MOUNT VERNON NEIGHBORHOOD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
MOUNT VERNON NEIGHBORHOOD HEALTH CENTER, INC.
Subdivision Name
MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH021500
Entity Address
107 W 4th St
Mount Vernon, NY 10550-4002
Grant Number
H80CS00161
Participating Start Date
9/9/2005
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
RL MT. VERNON PHARMACY INC
Pharmacy Address
107 WEST 4TH STREET
MT VERNON, NY 10550
Pharmacy Comments
Contract Details
Approval Date
11/6/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
11/06/2012- public health emergency declared in NY effective 10/27/2012
Contacts
Covered Entity Signing Official
CAROLE MORRIS, CEO
(914) 699-7200 Ext: 600
Contract Pharmacy Representative
LAURENCE MIRESSI, President
(914) 948-4141
Signed By Date
10/11/2012
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