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AMAZON PHARMACY #006
CH020620 Cornerstone Family Healthcare
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Covered Entity Details
Entity Name
Cornerstone Family Healthcare
Subdivision Name
Cornerstone Family Healthcare: The Kaplan Family Pavilion
Type
HRSA-Funded Health Center
340B ID
CH020620
Entity Address
147 Lake St
Newburgh, NY 12550
Grant Number
H80CS00469
Participating Start Date
1/1/1999
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #006
Pharmacy Address
3620 PLAINFIELD RD
INDIANAPOLIS, IN 46231-7003
Pharmacy Comments
Contract Details
Approval Date
1/13/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Jolly, CEO
(845) 220-3165
Contract Pharmacy Representative
AMAZON PHARMACY
JOHN M LAVIN, MANAGING OFFICER
(602) 793-8552
Signed By Date
1/13/2025
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