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COMMUNITY CARE RX INC.
CH02151BR Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Charles Evans Center, Inc - Hauppauge
Type
HRSA-Funded Health Center
340B ID
CH02151BR
Entity Address
305 Oser Avenue
Hauppauge, NY 11788
Grant Number
H80CS00313
Participating Start Date
10/1/2017
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
COMMUNITY CARE RX INC.
Pharmacy Address
131 SUNNYSIDE BLVD STE 100
PLAINVIEW, NY 11803
Pharmacy Comments
Contract Details
Approval Date
8/30/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allison Dubois, COO
(914) 734-8600 Ext: 78503
Contract Pharmacy Representative
Community Care Rx, Inc.
Nicholas Vartanian, Director of Corporate Development
(516) 418-8058 Ext: 101
Signed By Date
8/30/2023
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