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L D C PHARMACY CORP
CHC26631-00 LA CASA DE SALUD INC.
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Covered Entity Details
Entity Name
LA CASA DE SALUD INC.
Subdivision Name
La Casa de Salud, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC26631-00
Entity Address
966 Prospect Ave
Bronx, NY 10459-3270
Grant Number
H80CS26631
Participating Start Date
7/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
L D C PHARMACY CORP
Pharmacy Address
HEALTH CARE PHARMACY
1825 MADISON AVE
NEW YORK, NY 10035-3829
Pharmacy Comments
Contract Details
Approval Date
4/11/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Pamela Mattel, CEO
(718) 960-7601
Contract Pharmacy Representative
Health care Pharmacy
Mark Skopov, Pharmacist
(212) 369-5555
Signed By Date
4/1/2014
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