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LINDENWOOD RX CENTER INC
CH02002AP CARE FOR THE HOMELESS
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Covered Entity Details
Entity Name
CARE FOR THE HOMELESS
Subdivision Name
WILLOW FAMILY RESIDENCE
Type
HRSA-Funded Health Center
340B ID
CH02002AP
Entity Address
190 Willow Avenue
Bronx, NY 10454
Grant Number
H80CS00007
Participating Start Date
1/15/2013
Last Recertification Date
2/12/2018
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
LINDENWOOD RX CENTER INC
Pharmacy Address
LIRX
1380 LORING AVE
C/O PHARMACY
BROOKLYN, NY 11208
Pharmacy Comments
Contract Details
Approval Date
1/7/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Debbian Fletcher-Blake, Assistant Executive Director
(212) 366-4459 Ext: 207
Contract Pharmacy Representative
LIRX
Jitendra Patel, Director Of Pharmacy
(718) 277-0898
Signed By Date
1/7/2016
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