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FORDHAM ROAD PHARMACY
CH02002AM CARE FOR THE HOMELESS
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Covered Entity Details
Entity Name
CARE FOR THE HOMELESS
Subdivision Name
SUSAN'S PLACE
Type
HRSA-Funded Health Center
340B ID
CH02002AM
Entity Address
1911-21 JEROME AVE
BRONX, NY 10453
Grant Number
H80CS00007
Participating Start Date
7/1/2009
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
FORDHAM ROAD PHARMACY
Pharmacy Address
2 E FORDHAM ROAD
BRONX, NY 10468
Pharmacy Comments
Contract Details
Approval Date
4/12/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/3/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Regina Olasin, Chief Medical Officer
(212) 366-4459 Ext: 219
Contract Pharmacy Representative
Fordham Road RX
Ravi Chenna, President
(718) 364-3333
Signed By Date
4/12/2022
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