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MEDLY PHARMACY INC.
CH021887U SUNSET PARK HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
SUNSET PARK HEALTH COUNCIL, INC.
Subdivision Name
Metro Community Health Centers - Staten island
Type
HRSA-Funded Health Center
340B ID
CH021887U
Entity Address
2324 Forest Avenue
Staten Island, NY 10303
Grant Number
H80CS07914
Participating Start Date
4/1/2016
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
MEDLY PHARMACY INC.
Pharmacy Address
DBA MEDLY PHARMACY
31 DEBEVOISE ST
BROOKLYN, NY 11206-4196
Pharmacy Comments
Contract Details
Approval Date
4/5/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Larry K. McReynolds, Executive Director
(718) 630-7216
Contract Pharmacy Representative
Medley Pharmacy, Inc.
Scott Peck, Manager - Wellness Partnerships
(845) 893-2973
Signed By Date
4/5/2022
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