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BAYARD PHARMACY LLC
RWII19904 Kent Sussex Community Services, Inc.
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Covered Entity Details
Entity Name
Kent Sussex Community Services, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII19904
Entity Address
1241 College Park Drive
Dover, DE 19904
Grant Number
X07HA00081
Participating Start Date
7/1/2013
Last Recertification Date
2/5/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
BAYARD PHARMACY LLC
Pharmacy Address
202 W LOOCKERMAN ST
DOVER, DE 19904-3248
Pharmacy Comments
Contract Details
Approval Date
4/6/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Irene Curry, Administrative Assistant
(302) 672-8248
Contract Pharmacy Representative
Erik Mabus, Owner
(302) 526-4832
Signed By Date
4/6/2017
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