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CRESTWOOD HEALTH INC.
RWII12203 The Albany Damien Center, Inc.
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Covered Entity Details
Entity Name
The Albany Damien Center, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII12203
Entity Address
728 Madison Ave, Ste 100
Albany, NY 12208-3302
Grant Number
X07HA00044
Participating Start Date
10/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
CRESTWOOD HEALTH INC.
Pharmacy Address
CRESTWOOD PHARMACY
26-A PICOTTE DR.
ATTN: SUPERVISING PHARMACIST
ALBANY, NY 12208
Pharmacy Comments
Contract Details
Approval Date
7/10/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Perry Junjulas, Executive Director
(518) 449-7119 Ext: 102
Contract Pharmacy Representative
Crestwood Health, Inc.
Jagat Patel, Pharmacist-CEO
(518) 435-2315
Signed By Date
7/10/2024
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