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866 EAST TREMONT PHARMACY LLC
STD554081 University of Minnesota Youth and AIDS Projects
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Covered Entity Details
Entity Name
University of Minnesota Youth and AIDS Projects
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD554081
Entity Address
2929 4th ave south
203
Minneapolis, MN 55408
Grant Number
NH25PS005172
Participating Start Date
1/1/2022
Last Recertification Date
5/31/2024
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
11/30/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Valerie rubin Rubin-RaShaad, Executive Director
(651) 231-4849
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
10/15/2021
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