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THE STOP & SUPERMARKET CO
CH02152E OPEN DOOR FAMILY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
OPEN DOOR FAMILY MEDICAL CENTER, INC.
Subdivision Name
JOHN F. KENNEDY MAGNET SCHOOL
Type
HRSA-Funded Health Center
340B ID
CH02152E
Entity Address
40 Olivia St
Port Chester, NY 10573-4802
Grant Number
H80CS00160
Participating Start Date
11/25/2005
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
THE STOP & SUPERMARKET CO
Pharmacy Address
DBA STOP & SHOP PHARMACY #502
25 WATERFRONT PLACE
PORT CHESTER, NY 10573
Pharmacy Comments
Contract Details
Approval Date
5/1/2010
Contract Begin Date
5/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ANITA WILENKIN, COO
(914) 502-1452
Contract Pharmacy Representative
Gregg Jones, Director of Pharmacy Marketing and Clinical Programs
(617) 770-8101
Signed By Date
4/2/2010
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