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PHILADELPHIA PHARMACY
CH03167L PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
Congreso Health Center
Type
HRSA-Funded Health Center
340B ID
CH03167L
Entity Address
216 W. Somerset St.
Philadelphia, PA 19133
Grant Number
H80CS00016
Participating Start Date
4/1/2012
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
PHILADELPHIA PHARMACY
Pharmacy Address
101 E LEHIGH AVENUE
PHILADELPHIA, PA 19125
Pharmacy Comments
Contract Details
Approval Date
4/13/2012
Contract Begin Date
4/13/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard J. Cohen, President
(215) 985-2501
Contract Pharmacy Representative
Richard Ost, Pharmacist and Owner
(215) 425-2800
Signed By Date
4/2/2012
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