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COORDINATED CARE NETWORK PHARMACY
CH03167J PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
PHMC Care Clinic
Type
HRSA-Funded Health Center
340B ID
CH03167J
Entity Address
1200 Callowhill St
Philadelphia, PA 19123-3658
Grant Number
H80CS00016
Participating Start Date
10/1/2010
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
249 S 13TH ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
3/31/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/31/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Richard Cohen, President and CEO
(215) 985-2501
Contract Pharmacy Representative
CCN AMERICA LP
Thomas J. Pollack, Vice President and CFO
(412) 349-6303
Signed By Date
3/31/2015
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