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ELDER PHARMACY LLC
CH02360AE URBAN HEALTH PLAN, INC.
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Covered Entity Details
Entity Name
URBAN HEALTH PLAN, INC.
Subdivision Name
Park Tree Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH02360AE
Entity Address
866 E Tremont Ave
Bronx, NY 10460-4201
Grant Number
H80CS00368
Participating Start Date
10/1/2022
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
ELDER PHARMACY LLC
Pharmacy Address
D/B/A LEROY PHARMACY
1527 WESTCHESTER AVE
BRONX, NY 10472-2908
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paloma Hernandez, President and CEO
(718) 589-2440 Ext: 4219
Contract Pharmacy Representative
Elder Pharmacy, LLC.
Sanjiv Seth, CEO
(917) 670-9484
Signed By Date
10/13/2022
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