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PHYSICIANS RX PHARMACY, LLC
CHC22679-00 ELAINE ELLIS CENTER OF HEALTH
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Covered Entity Details
Entity Name
ELAINE ELLIS CENTER OF HEALTH
Subdivision Name
Elaine Ellis Center of Health
Type
HRSA-Funded Health Center
340B ID
CHC22679-00
Entity Address
1627 Kenilworth Ave NE
Washington, DC 20019-2010
Grant Number
H80CS22679
Participating Start Date
10/1/2014
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
PHYSICIANS RX PHARMACY, LLC
Pharmacy Address
7525 GREENWAY CENTER DRIVE SUITE 202
GREENBELT, MD 20770
Pharmacy Comments
Contract Details
Approval Date
10/16/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timothy Walker, COO
(202) 803-2340
Contract Pharmacy Representative
Donald Smith, CEO
(301) 477-3367
Signed By Date
10/16/2014
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