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866 EAST TREMONT PHARMACY LLC
RWI303141 Georgia Harm Reduction Coalition, Inc
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Covered Entity Details
Entity Name
Georgia Harm Reduction Coalition, Inc
Subdivision Name
Type
Ryan White Part A
340B ID
RWI303141
Entity Address
759 Joseph E Boone BLVD
Atlanta, GA 30314
Grant Number
UT8HA33933
Participating Start Date
10/1/2023
Last Recertification Date
2/10/2025
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
8/18/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mojgan Zare, CEO
(404) 817-9994
Contract Pharmacy Representative
Boca Pharmacy
Jacob Jamron, CEO
(718) 991-6700
Signed By Date
7/13/2023
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