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ALLIANCE PA PHARMACY, LLC.
CHC00064-03 ODA PRIMARY HEALTH CARE CENTER, INC.
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Covered Entity Details
Entity Name
ODA PRIMARY HEALTH CARE CENTER, INC.
Subdivision Name
ODA Woodridge Health Care Center
Type
HRSA-Funded Health Center
340B ID
CHC00064-03
Entity Address
6 Dairyland Rd
Woodridge, NY 12789-0000
Grant Number
H80CS00064
Participating Start Date
7/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
ALLIANCE PA PHARMACY, LLC.
Pharmacy Address
1235 PENN AVE STE 101
WYOMISSING, PA 19610-2100
Pharmacy Comments
Contract Details
Approval Date
4/11/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Deutsch, Chief Executive Officer
(718) 260-4600 Ext: 301
Contract Pharmacy Representative
Alliance PA Pharmacy
Joel Grodman, Pharmacist
(973) 589-5000
Signed By Date
4/11/2022
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