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GUY BREWER PHARMACY INC
CH02211K THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC
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Covered Entity Details
Entity Name
THE ADDABBO JOSEPH P FAMILY HEALTH CENTER INC
Subdivision Name
Joseph P. Addabbo Family Health Center, Inc. - Ozone Park
Type
HRSA-Funded Health Center
340B ID
CH02211K
Entity Address
10534 Rockaway Blvd
Ozone Park, NY 11417-2306
Grant Number
H80CS00430
Participating Start Date
10/1/2014
Last Recertification Date
2/20/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
GUY BREWER PHARMACY INC
Pharmacy Address
11717 GUY R BREWER BLVD
JAMAICA, NY 11434-2148
Pharmacy Comments
Contract Details
Approval Date
6/28/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
10/1/2017
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Majorie J. Hill, CEO
(718) 945-7150 Ext: 1308
Contract Pharmacy Representative
GuyBrewer
SIMON BATUROV, PRINCIPAL/SUPERVISING PHARMACIST
(718) 525-5005
Signed By Date
6/28/2017
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