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1875 LEXINGTON AVENUE CORP OF NEW YORK
CH021917A 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
Willis P Green Health Center
Type
HRSA-Funded Health Center
340B ID
CH021917A
Entity Address
123-125 West 124th St
New York, NY 10027-4920
Grant Number
H80CS17251
Participating Start Date
7/1/2008
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
1875 LEXINGTON AVENUE CORP OF NEW YORK
Pharmacy Address
D/B/A QUICK RX
1875 LEXINGTON AVENUE
NEW YORK, NY 10035-1003
Pharmacy Comments
Contract Details
Approval Date
4/14/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tamisha M McPherson, EXECUTIVE DIRECTOR
(212) 803-2850 Ext: 2444
Contract Pharmacy Representative
Quick Rx Pharmacy Group
Elan Katz, CEO
(917) 733-4301
Signed By Date
4/14/2016
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