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MAXOR SPECIALTY PHARMACY
CH02152G OPEN DOOR FAMILY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
OPEN DOOR FAMILY MEDICAL CENTER, INC.
Subdivision Name
OPEN DOOR MT. KISCO CLINIC
Type
HRSA-Funded Health Center
340B ID
CH02152G
Entity Address
30 W MAIN ST
MOUNT KISCO, NY 10549-1910
Grant Number
H80CS00160
Participating Start Date
11/25/2005
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MAXOR SPECIALTY PHARMACY
Pharmacy Address
216 S POLK ST
AMARILLO, TX 79101-1407
Pharmacy Comments
Contract Details
Approval Date
11/7/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
11/07/2012 - public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
9/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lindsay Farrell, President and CEO
(914) 502-1450
Contract Pharmacy Representative
Jan Robinson, Vice President of Operations, Maxor Specialty and IV Solutions
(806) 324-5461
Signed By Date
10/5/2012
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