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866 EAST TREMONT PHARMACY LLC
STD01608 AIDS Project Worcester Inc.
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Covered Entity Details
Entity Name
AIDS Project Worcester Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD01608
Entity Address
165 Southbridge Street
WORCESTER, MA 01608
Grant Number
NH25PS005167
Participating Start Date
4/1/2023
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
866 EAST TREMONT PHARMACY LLC
Pharmacy Address
BOCA PHARMACY
864B E TREMONT AVE
BRONX, NY 10460
Pharmacy Comments
Contract Details
Approval Date
2/9/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Smith, CEO
(508) 755-3773
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
1/11/2023
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