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ACARIAHEALTH PHARMACY #12, INC.
CH022110 THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC
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Covered Entity Details
Entity Name
THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC
Subdivision Name
JOSEPH P. ADDABBO FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH022110
Entity Address
6200 Beach Channel Dr
Arverne, NY 11692-1409
Grant Number
H80CS00430
Participating Start Date
4/1/2003
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
ACARIAHEALTH PHARMACY #12, INC.
Pharmacy Address
5 SKYLINE DR STE 240
HAWTHORNE, NY 10532-2166
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
miriam Vega, CEO
(718) 945-7150 Ext: 1308
Contract Pharmacy Representative
Acaria Health Pharmacy
Islam Kurti, Pharmacy Director
(800) 511-5144
Signed By Date
4/15/2022
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