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MT. WELCOME PHARMACY INC.
HV17151 FREDERIKSTED HEALTH CARE, INC.
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Covered Entity Details
Entity Name
FREDERIKSTED HEALTH CARE, INC.
Subdivision Name
Ryan White
Type
Ryan White Part C
340B ID
HV17151
Entity Address
516 Strand Street
Frederiksted, VI 00840
Grant Number
H76HA17151
Participating Start Date
10/1/2010
Last Recertification Date
1/31/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
MT. WELCOME PHARMACY INC.
Pharmacy Address
MT. WELCOME PHARMACY-PRINCESSE
4-A & 4-AA LA GRANDE PRINCESS
C/O 4040 LA GRANDE PRINCESS SUITE 4A
CHRISTIANSTED, VI 00820
Pharmacy Comments
Contract Details
Approval Date
1/31/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Masserae Sprauve Webster, Chief Executive Officer
(340) 772-1992 Ext: 2132
Contract Pharmacy Representative
Mt. Welcome Pharmacy
Steve Eckstein, Owner
(540) 529-7300
Signed By Date
1/31/2024
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