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GOLD STREET PHARMA INC.
CH02371BN INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
Cadman Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH02371BN
Entity Address
300 Cadman Plaza W
Brooklyn, NY 11201-3229
Grant Number
H80CS00768
Participating Start Date
10/1/2017
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
GOLD STREET PHARMA INC.
Pharmacy Address
NICK'S PHARMACY
111 GOLD ST
BROOKLYN, NY 11201
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Caroline DiCioccio, Chief Financial Officer
(212) 633-0800 Ext: 1409
Contract Pharmacy Representative
Gold Street Pharma Inc.
Ravi K. Chenna, President
(646) 425-4405
Signed By Date
10/16/2023
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