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SUNRAY DRUGS CHESTNUT PLAZA
RWII19063 Family and Community Service of Delaware County
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Covered Entity Details
Entity Name
Family and Community Service of Delaware County
Subdivision Name
Type
Ryan White Part B
340B ID
RWII19063
Entity Address
600 N Olive St
Media, PA 19063
Grant Number
X07HA00021
Participating Start Date
4/1/2014
Last Recertification Date
1/30/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
SUNRAY DRUGS CHESTNUT PLAZA
Pharmacy Address
SUNRAY DRUGS CHESTNUT PLAZA
4323 CHESTNUT ST
PHILADELPHIA, PA 19104
Pharmacy Comments
Contract Details
Approval Date
7/8/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alan Edelstein, Executive Director
(610) 566-7540
Contract Pharmacy Representative
Bradley Tabaac, Manager
(215) 425-5230
Signed By Date
7/8/2015
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