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LENOX TERRACE PHARMACY INC
CH0219170 UPPER ROOM AIDS MINISTRY, INC.: ADULT DAY HEALTH CARE CENTER
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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
LENOX TERRACE PHARMACY INC
Pharmacy Address
DBA: LENOX TERRACE DRUGS
20 W 135TH ST
NEW YORK, NY 10037-2534
Pharmacy Comments
Contract Details
Approval Date
10/14/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelsey Louie, EXECUTIVE DIRECTOR
(212) 803-2850
Contract Pharmacy Representative
Abdul Wahab Mohammed Qureshi, Supervising Pharmacist
(212) 234-2050
Signed By Date
10/14/2013
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