Contract Pharmacy Details

WATSONS PHARMACY LLC
CH02848B DAMIAN FAMILY CARE CENTERS, INC.

Covered Entity Details

Entity Name

DAMIAN FAMILY CARE CENTERS, INC.

Subdivision Name

Highbridge Clinic

Type

HRSA-Funded Health Center

340B ID

CH02848B

Entity Address

1381 University Ave
Bronx, NY 10452-4050

Grant Number

H80CS01765

Participating Start Date

4/12/2013

Last Recertification Date

1/30/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

WATSONS PHARMACY LLC

Pharmacy Address

192-21 STATION RD
FLUSHING, NY 11358-2956

Pharmacy Comments

Contract Details

Approval Date

4/8/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

John Chue, CFO
(718) 657-1100 Ext: 4116

Contract Pharmacy Representative

Jerry Louie, Pharmacist
(718) 359-1188

Signed By Date

4/8/2014