Contract Pharmacy Details

ISLAND CARE PHARMACY INC
RWII12203 The Albany Damien Center, Inc.

Covered Entity Details

Entity Name

The Albany Damien Center, Inc.

Subdivision Name

Type

Ryan White Part B

340B ID

RWII12203

Entity Address

728 Madison Ave, Ste 100
Albany, NY 12208-3302

Grant Number

X07HA00044

Participating Start Date

10/1/2015

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

ISLAND CARE PHARMACY INC

Pharmacy Address

PARAMOUNT SPECIALTY PHARMACY
150 NEW SCOTLAND AVE
ALBANY, NY 12208-3423

Pharmacy Comments

Contract Details

Approval Date

4/3/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/25/2018
Pharmacy closed

Contacts

Covered Entity Signing Official

Perry Junjulas, Executive Director
(518) 449-7119 Ext: 102

Contract Pharmacy Representative

Paramount SPecialty
Al DosSantos, Founding Principle
(631) 815-5776

Signed By Date

4/3/2017

340B Drug Pricing Program Database