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DM CLINICAL COLLABORATIONS
HM19134 St. Christopher's Pediatric Associates
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Covered Entity Details
Entity Name
St. Christopher's Pediatric Associates
Subdivision Name
Hematology - E. Erie Avenue
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM19134
Entity Address
160 E. Erie Avenue
Section of Hematology, 2nd Floor Nelson Building
Philadelphia, PA 19134-1095
Grant Number
H30MC48960
Participating Start Date
1/1/2023
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
DM CLINICAL COLLABORATIONS
Pharmacy Address
DBA INFUCARE RX
6108 SAN FERNANDO RD
GLENDALE, CA 91201-2240
Pharmacy Comments
Contract Details
Approval Date
7/18/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Edward Bleacher, Chief Financial Officer
(610) 506-6265
Contract Pharmacy Representative
Infucare
Mark Milburn, 340B Director
(877) 828-3940
Signed By Date
7/18/2023
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