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FOUNDATION CARE LLC
CH024690 COMMUNITY HEALTH CENTER OF BUFFALO, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF BUFFALO, INC.
Subdivision Name
34 Benwood Ave Buffalo, NY 14214
Type
HRSA-Funded Health Center
340B ID
CH024690
Entity Address
34 Benwood
Buffalo, NY 14214-1761
Grant Number
H80CS00157
Participating Start Date
4/1/2003
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
FOUNDATION CARE LLC
Pharmacy Address
111 CHESTERFIELD INDUSTRIAL BLVD STE 115
CHESTERFIELD, MO 63005
Pharmacy Comments
Contract Details
Approval Date
10/7/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
LaVonne Ansari, CEO
(716) 986-9199 Ext: 1002
Contract Pharmacy Representative
Acaria Health
Philip Gofman, Regional VP
(917) 312-5263
Signed By Date
10/7/2022
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