Contract Pharmacy Details

PVR DRUGS, INC.
CHC26191-12 Housing Works Health Services III, Inc.

Covered Entity Details

Entity Name

Housing Works Health Services III, Inc.

Subdivision Name

Temporary Site - Holiday Inn Express LaGuardia

Type

HRSA-Funded Health Center

340B ID

CHC26191-12

Entity Address

113-10 Horace Harding Expressway
Queens, NY 11368-5136

Grant Number

H80CS26191

Participating Start Date

7/16/2021

Last Recertification Date

2/1/2023

Entity Termination Date

10/1/2023

Pharmacy Details

Pharmacy Name

PVR DRUGS, INC.

Pharmacy Address

DBA HEALTHCARE PHARMACY
337 E 149TH ST
BRONX, NY 10451

Pharmacy Comments

Contract Details

Approval Date

4/18/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Patricia Troy, SVP, Healthcare Services
(347) 473-7458

Contract Pharmacy Representative

PVR Drugs Inc
Venkat Juluru, Vice President/Owner
(718) 585-1117

Signed By Date

4/18/2023

340B Drug Pricing Program Database