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PRXP OF NEW YORK LLC
CH041190 BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
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Covered Entity Details
Entity Name
BEAUFORT-JASPER-HAMPTON COMPREHENSIVE HEALTH SERVICES, INCORPORATED
Subdivision Name
RUTH P. FIELD MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH041190
Entity Address
719 N Okatie Hwy
Ridgeland, SC 29936-8276
Grant Number
H80CS00699
Participating Start Date
12/1/1992
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
PRXP OF NEW YORK LLC
Pharmacy Address
DBA BROADWAY FAMILY PHARMACY
601 AMSTERDAM AVE
NEW YORK, NY 10024
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Faith L Polkey, CEO
(843) 987-7448
Contract Pharmacy Representative
Physicians Rx Pharmacy of Clinton
Chris Wakefield, Manager
(412) 357-5163
Signed By Date
7/15/2024
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