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DULARI CORP.
CH02848D DAMIAN FAMILY CARE CENTERS, INC.
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Covered Entity Details
Entity Name
DAMIAN FAMILY CARE CENTERS, INC.
Subdivision Name
Ellenville Health Center
Type
HRSA-Funded Health Center
340B ID
CH02848D
Entity Address
751 BRIGGS HWY
ELLENVILLE, NY 12428-5501
Grant Number
H80CS01765
Participating Start Date
4/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
DULARI CORP.
Pharmacy Address
QUEENS DRUGS & SURGICAL
146-14 JAMAICA AVE
ATTN: SUPERVISING PHARMACIST
JAMAICA, NY 11435-3628
Pharmacy Comments
Contract Details
Approval Date
4/7/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Chue, CFO
(718) 657-1100 Ext: 4116
Contract Pharmacy Representative
Samir Sutaria, Pharmacist
(718) 297-0099
Signed By Date
4/7/2014
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