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THE STOP & SUPERMARKET CO
CH02152I OPEN DOOR FAMILY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
OPEN DOOR FAMILY MEDICAL CENTER, INC.
Subdivision Name
PORT CHESTER MIDDLE SCHOOL - SBHC
Type
HRSA-Funded Health Center
340B ID
CH02152I
Entity Address
113 Bowman Avenue
Port Chester, NY 10573-2808
Grant Number
H80CS00160
Participating Start Date
7/1/2010
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
THE STOP & SUPERMARKET CO
Pharmacy Address
DBA STOP & SHOP PHARMACY #502
25 WATERFRONT PLACE
PORT CHESTER, NY 10573
Pharmacy Comments
Contract Details
Approval Date
12/13/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
12/13/2012 - public health emergency declared in the state of NY effective 10/27/2012
Contacts
Covered Entity Signing Official
Lindsay Farrell, President and CEO
(914) 502-1450
Contract Pharmacy Representative
Gregg Jones, Director of Pharmacy Marketing and Clinical Programs
(617) 770-8101
Signed By Date
11/12/2012
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