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AVS RX
CH02151CD Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Sun River Health Church Avenue Clinic
Type
HRSA-Funded Health Center
340B ID
CH02151CD
Entity Address
2412 Church Ave
Brooklyn, NY 11226-4005
Grant Number
H80CS00313
Participating Start Date
4/1/2019
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
AVS RX
Pharmacy Address
DBA: RUBIN CHEMISTS
828 NOSTRAND AVE
BROOKLYN, NY 11216-4403
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
Allison Dubois, COO
(914) 734-8600 Ext: 78503
Contract Pharmacy Representative
Rubin Chemists
Krishna Inapuri, Supervising Pharmacists
(718) 493-8833
Signed By Date
10/16/2023
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