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COLUMBIA HEIGHT PROFESS PHARM
RWIID72 District of Columbia Department of Health
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Covered Entity Details
Entity Name
District of Columbia Department of Health
Subdivision Name
HIV/AIDS, Hepatitis, STD & TB Administration
Type
Ryan White Part B ADAP Direct Purchase
340B ID
RWIID72
Entity Address
2201 Shannon Place SE
Third Floor
Suite 334
WASHINGTON, DC 20020
Grant Number
X07HA00045
Participating Start Date
11/17/2011
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
COLUMBIA HEIGHT PROFESS PHARM
Pharmacy Address
SIERRA INT'L PHARMACEUTICAL
3316 14TH ST NW
WASHINGTON, DC 20010-2302
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tayiana Reed, Chief of ADAP
(202) 671-4810
Contract Pharmacy Representative
sahr bockai, Owner
(202) 232-1455
Signed By Date
7/17/2017
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