Contract Pharmacy Details

SLEEPY HOLLOW PHARMACY INC.
CH02152A OPEN DOOR FAMILY MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

OPEN DOOR FAMILY MEDICAL CENTER, INC.

Subdivision Name

OPEN DOOR FAM MED--SLEEPY HOLLOW

Type

HRSA-Funded Health Center

340B ID

CH02152A

Entity Address

300 North Broadway
Sleepy Hollow, NY 10591-2370

Grant Number

H80CS00160

Participating Start Date

4/1/1995

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

SLEEPY HOLLOW PHARMACY INC.

Pharmacy Address

95 BEEKMAN AVE # 4
SLEEPY HOLLOW, NY 10591-2549

Pharmacy Comments

Contract Details

Approval Date

11/17/2005

Contract Begin Date

11/17/2005

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/30/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

11/16/2005

340B Drug Pricing Program Database