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SULLIVAN'S HEALTH CARE
CH01060A FENWAY COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
FENWAY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Fenway: South End
Type
HRSA-Funded Health Center
340B ID
CH01060A
Entity Address
142 Berkeley St
Boston, MA 02116-5100
Grant Number
H80CS00303
Participating Start Date
4/1/2008
Last Recertification Date
2/12/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
SULLIVAN'S HEALTH CARE
Pharmacy Address
30 BELGRADE AVE
BOSTON, MA 02131-3006
Pharmacy Comments
Contract Details
Approval Date
2/20/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/10/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JEFFREY LIEBERMAN, VP of Finance
(617) 927-6173
Contract Pharmacy Representative
Timothy Fensky, Director, Pharmacy Operation
(617) 323-6544
Signed By Date
1/14/2013
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