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PARK RIDGE APOTHECARY INC
CH020560 Mosaic Health, Inc.
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Covered Entity Details
Entity Name
Mosaic Health, Inc.
Subdivision Name
Mosaic Health Finger Lakes Administration
Type
HRSA-Funded Health Center
340B ID
CH020560
Entity Address
1 S Washington Street
Suite 300
Rochester, NY 14614-1134
Grant Number
H80CS00167
Participating Start Date
9/9/2005
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PARK RIDGE APOTHECARY INC
Pharmacy Address
DBA: GENESEE CAMPUS APOTHECARY
GENESEE CAMPUS APOTHECARY
89 GENESEE ST
ROCHESTER, NY 14611-3201
Pharmacy Comments
Contract Details
Approval Date
7/15/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael J Leary, President/CEO
(585) 325-2280 Ext: 7302
Contract Pharmacy Representative
Laura Speidel, Supervising Pharmacist
(585) 368-3928
Signed By Date
7/15/2014
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