Contract Pharmacy Details

SUN RAY DRUG, LLC
CH03414A SPECTRUM HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

SPECTRUM HEALTH SERVICES, INC.

Subdivision Name

BROAD STREET HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH03414A

Entity Address

1415 N Broad St STE 224
Philadelphia, PA 19122-3325

Grant Number

H80CS00389

Participating Start Date

10/1/2016

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

SUN RAY DRUG, LLC

Pharmacy Address

142 S 52ND STREET
PHILADELPHIA, PA 19139

Pharmacy Comments

Contract Details

Approval Date

10/5/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Shawna L Russell-Young, Chief Compliance Officer
(215) 668-0847

Contract Pharmacy Representative

Sunray Drugs
Marcus Tancredi, Owner
(856) 278-1647

Signed By Date

10/5/2023

340B Drug Pricing Program Database