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PHARMACY ON FIFTH INC
CH021887A SUNSET PARK HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
SUNSET PARK HEALTH COUNCIL, INC.
Subdivision Name
FAMILY PHYSICIAN FAMILY HEALTH CENTER at NYU Langone
Type
HRSA-Funded Health Center
340B ID
CH021887A
Entity Address
5616 - 6TH AVE
BROOKLYN, NY 11220
Grant Number
H80CS07914
Participating Start Date
1/1/2004
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
PHARMACY ON FIFTH INC
Pharmacy Address
6914 5TH AVE
ATTN: SUPERVISING PHARMACIST
BROOKLYN, NY 11209-1507
Pharmacy Comments
Contract Details
Approval Date
4/5/2013
Contract Begin Date
4/5/2013
Carve-In Effective Date
Contract Comments
04/09/2013 - Public health emergency declared in NY effective 10/27/2012
Contract Termination Date
Termination Reason
12/1/2016
Pharmacy closed
Contacts
Covered Entity Signing Official
LARRY MCREYNOLDS, CEO
(718) 630-7216
Contract Pharmacy Representative
Habib Joudeh, Owners
(718) 238-9600
Signed By Date
4/5/2013
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