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ISLAND INFUSION PHARMACY INC
CH021260 CORPORACION DE SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO
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Covered Entity Details
Entity Name
CORPORACION DE SERVICIOS MEDICOS PRIMARIOS Y PREVENCION DE HATILLO
Subdivision Name
CSM Medical Tower
Type
HRSA-Funded Health Center
340B ID
CH021260
Entity Address
Carr.2 Km 86.6 Bo. Pueblo
HATILLO, PR 00659
Grant Number
H80CS00334
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
ISLAND INFUSION PHARMACY INC
Pharmacy Address
ISLAND INFUSION PHARMACY
123 CALLE RODRIGO DE TRIANA
URB EL VEDADO
SAN JUAN, PR 00918
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lorena Torres Mercado, CEO
(787) 898-4190 Ext: 406
Contract Pharmacy Representative
Island Infusion Pharmacy
Rafael Rivera, Administrator
(787) 393-0040
Signed By Date
1/11/2024
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