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DUANE READE
FQHCLA306 APICHA Community Health Center
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Covered Entity Details
Entity Name
APICHA Community Health Center
Subdivision Name
Type
Health Center Program Look-Alike
340B ID
FQHCLA306
Entity Address
400 Broadway
New York, NY 10013
Grant Number
LALCS00137
Participating Start Date
10/27/2012
Last Recertification Date
2/11/2015
Entity Termination Date
1/1/2016
Pharmacy Details
Pharmacy Name
DUANE READE
Pharmacy Address
2683 BROADWAY # 7
NEW YORK, NY 10025
Pharmacy Comments
Contract Details
Approval Date
1/8/2013
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
01/08/2013 - public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
1/1/2016
Contacts
Covered Entity Signing Official
Teresita R. Rodriguez, Chief Executive Officer
(212) 334-7940
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/2/2013
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