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LINCOLN PLACE PHARMACY INC
CH02212F Bedford Stuyvesant Family Health Center, Inc., The
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Covered Entity Details
Entity Name
Bedford Stuyvesant Family Health Center, Inc., The
Subdivision Name
BROADWAY FAMILY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH02212F
Entity Address
1238 Broadway
Brooklyn, NY 11221-2906
Grant Number
H80CS00510
Participating Start Date
10/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
LINCOLN PLACE PHARMACY INC
Pharmacy Address
1135 EASTERN PKWY
BROOKLYN, NY 11213
Pharmacy Comments
Contract Details
Approval Date
1/25/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Patricia Fernandez, President/CEO
(718) 636-4500 Ext: 6531
Contract Pharmacy Representative
Lincoln Place
Arshad Tariq, Owner
(718) 756-1717
Signed By Date
1/25/2017
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