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PARK RIDGE APOTHECARY INC
CHC11274-05 UNITY HOSPITAL OF ROCHESTER, THE
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Covered Entity Details
Entity Name
UNITY HOSPITAL OF ROCHESTER, THE
Subdivision Name
SALVATION ARMY BOOTH HAVEN
Type
HRSA-Funded Health Center
340B ID
CHC11274-05
Entity Address
70 LIBERTY POLE WAY
ROCHESTER, NY 14604-1410
Grant Number
H80CS11274
Participating Start Date
1/1/2015
Last Recertification Date
2/20/2017
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
PARK RIDGE APOTHECARY INC
Pharmacy Address
DBA: GENESEE CAMPUS APOTHECARY
GENESEE CAMPUS APOTHECARY
89 GENESEE ST
ROCHESTER, NY 14611-3201
Pharmacy Comments
Contract Details
Approval Date
10/23/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Laura Speidel, R.Ph.
(585) 368-3928
Signed By Date
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