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866 EAST TREMONT PHARMACY LLC
STD28403 SEEDS of Healing Inc
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Covered Entity Details
Entity Name
SEEDS of Healing Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD28403
Entity Address
3804 Juvenile Center Rd #2
Castle Hayne, NC 28429
Grant Number
NH25PS005152-01
Participating Start Date
10/1/2023
Last Recertification Date
5/13/2024
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
8/31/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LeShonda Wallace, Executive Director
(910) 390-6005
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
7/11/2023
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