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866 EAST TREMONT PHARMACY LLC
RWII67202 POSITIVE DIRECTIONS INC
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Covered Entity Details
Entity Name
POSITIVE DIRECTIONS INC
Subdivision Name
Type
Ryan White Part B
340B ID
RWII67202
Entity Address
154 N Topeka
Wichita, KS 67202
Grant Number
X08HA33781
Participating Start Date
4/1/2023
Last Recertification Date
2/18/2025
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
7/6/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brett Hogan, Exec Dir
(316) 263-2214
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
7/6/2023
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