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BEACON WELLNESS PHARMACY INC
CH021510 Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Sun River Health Peekskill
Type
HRSA-Funded Health Center
340B ID
CH021510
Entity Address
1037 Main St
Peekskill, NY 10566-2913
Grant Number
H80CS00313
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
BEACON WELLNESS PHARMACY INC
Pharmacy Address
333 MAIN ST
BEACON, NY 12508
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Allison Dubois-Adach, COO
(914) 734-8503
Contract Pharmacy Representative
BEACON WELLNESS PHARMACY INC
Enrique Reynoso, CEO
(845) 765-8878
Signed By Date
7/15/2022
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