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NOVEL RX LLC
CHC26191-06 Housing Works Health Services III, Inc.
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Covered Entity Details
Entity Name
Housing Works Health Services III, Inc.
Subdivision Name
125th Street Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26191-06
Entity Address
145 East 125th Street Fl 3-4
New York, NY 10035-2809
Grant Number
H80CS26191
Participating Start Date
7/1/2020
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
NOVEL RX LLC
Pharmacy Address
ERINS PHARMACY
360 E 4TH ST
NEW YORK, NY 10009
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patricia Troy, SVP, Healthcare Services
(347) 473-7458
Contract Pharmacy Representative
Novel Rx LLC
Murali Mupparaju, President
(251) 408-7261
Signed By Date
1/16/2024
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