Contract Pharmacy Details

L D C PHARMACY CORP
CH0219170 UPPER ROOM AIDS MINISTRY, INC.: ADULT DAY HEALTH CARE CENTER

Covered Entity Details

Entity Name

UPPER ROOM AIDS MINISTRY, INC.: ADULT DAY HEALTH CARE CENTER

Subdivision Name

Mobile Health Services

Type

HRSA-Funded Health Center

340B ID

CH0219170

Entity Address

227 E 125th St
New York, NY 10035-1739

Grant Number

H80CS17251

Participating Start Date

7/1/2008

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

L D C PHARMACY CORP

Pharmacy Address

HEALTH CARE PHARMACY
1825 MADISON AVE
NEW YORK, NY 10035-3829

Pharmacy Comments

Contract Details

Approval Date

10/11/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/1/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Kelsey Louie, EXECUTIVE DIRECTOR
(212) 803-2850

Contract Pharmacy Representative

Health care Pharmacy
Mark Skopov, Pharmacist
(212) 369-5555

Signed By Date

10/11/2013

340B Drug Pricing Program Database