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PRXP OF NEW YORK LLC
CHC31240-01 FIRST PERSON CARE CLINIC
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Covered Entity Details
Entity Name
FIRST PERSON CARE CLINIC
Subdivision Name
FIRST PERSON CARE CLINIC
Type
HRSA-Funded Health Center
340B ID
CHC31240-01
Entity Address
916 W Owens Ave
Las Vegas, NV 89106-2516
Grant Number
H80CS31240
Participating Start Date
4/1/2024
Last Recertification Date
2/26/2025
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
10/11/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diego Martinez, CEO
(305) 992-5149
Contract Pharmacy Representative
Physicians Rx Pharmacy of Clinton
Chris Wakefield, Manager
(412) 357-5163
Signed By Date
10/11/2024
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