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DELIVERCARERX PHARMACY LLC
CH020160 SYRACUSE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
SYRACUSE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
SYRACUSE COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH020160
Entity Address
819 S Salina St
Syracuse, NY 13202-3527
Grant Number
H80CS00434
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
DELIVERCARERX PHARMACY LLC
Pharmacy Address
DELIVERCARERX PHARMACY LLC
1471 E BUSINESS CENTER DR
STE 200
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
7/28/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/5/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Leola Rodgers, President and CEO
(315) 476-7921 Ext: 2427
Contract Pharmacy Representative
Agape
Dave Krishna, CEO
(847) 965-1600
Signed By Date
7/28/2017
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