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FEDCO CHEMIST PHARMACY CORP.
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
FEDCO CHEMIST PHARMACY CORP.
Pharmacy Address
D/B/A FEDCO CHEMIST PHARMACY
512 SOUTH BROADWAY
YONKERS, NY 10705
Pharmacy Comments
Contract Details
Approval Date
10/12/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/15/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Allison Dubois-Adach, COO
(914) 734-8503
Contract Pharmacy Representative
FEDCO CHEMIST PHARMACY CORP.
Emanuel Mullokandov, Owner
(914) 294-0501
Signed By Date
10/12/2022
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