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PHARMACY OF AMERICA IV
CH03167K PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
PHMC health Connection
Type
HRSA-Funded Health Center
340B ID
CH03167K
Entity Address
1900 N 9th St
Philadelphia, PA 19122
Grant Number
H80CS00016
Participating Start Date
10/1/2010
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
PHARMACY OF AMERICA IV
Pharmacy Address
1900 N 9TH ST
PHILADELPHIA, PA 19122
Pharmacy Comments
Contract Details
Approval Date
10/1/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARINO PULITI, CFO
(215) 985-2503
Contract Pharmacy Representative
Pharmacy of America
Sabri Ibrahim, President and CEO
(215) 744-0300
Signed By Date
10/1/2013
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