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866 EAST TREMONT PHARMACY LLC
STD300831 Georgia Harm Reduction Coalition, Inc
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Covered Entity Details
Entity Name
Georgia Harm Reduction Coalition, Inc
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD300831
Entity Address
401 creekstone Ridge
woodstock, GA 30083
Grant Number
NU62PS924696
Participating Start Date
10/1/2023
Last Recertification Date
5/6/2024
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
8/8/2023
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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