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SOUTHSIDE PHARMACY AND HEALTH SHOP LLC
CHC00064-01 ODA PRIMARY HEALTH CARE CENTER, INC.
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Covered Entity Details
Entity Name
ODA PRIMARY HEALTH CARE CENTER, INC.
Subdivision Name
ODA Professionals
Type
HRSA-Funded Health Center
340B ID
CHC00064-01
Entity Address
329 Hewes Street
Brooklyn, NY 11211-7489
Grant Number
H80CS00064
Participating Start Date
10/1/2013
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SOUTHSIDE PHARMACY AND HEALTH SHOP LLC
Pharmacy Address
SOUTH SIDE PHARMACY
432 BEDFORD AVE
BROOKLYN, NY 11249-6588
Pharmacy Comments
Contract Details
Approval Date
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/18/2024
OPA Terminated due to audit finding
Contacts
Covered Entity Signing Official
Joseph Deutsch, Chief Executive Officer
(718) 260-4600 Ext: 301
Contract Pharmacy Representative
Isreal Schiff, owner
(714) 141-2414
Signed By Date
1/17/2017
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