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STAND PHARMACY
CH02360AD URBAN HEALTH PLAN, INC.
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Covered Entity Details
Entity Name
URBAN HEALTH PLAN, INC.
Subdivision Name
Fannie Lou Hamer M.S./P.S. 66
Type
HRSA-Funded Health Center
340B ID
CH02360AD
Entity Address
1001 Jennings St
Bronx, NY 10460-6032
Grant Number
H80CS00368
Participating Start Date
10/1/2022
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
STAND PHARMACY
Pharmacy Address
1515 SOUTHERN BLVD
BRONX, NY 10460
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
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
Paloma Hernandez, President and CEO
(718) 589-2440 Ext: 4219
Contract Pharmacy Representative
Stand Pharmacy
Rubbab Sehar, President
(201) 899-8131
Signed By Date
10/13/2022
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