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STAND PHARMACY
CH02360T URBAN HEALTH PLAN, INC.
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Covered Entity Details
Entity Name
URBAN HEALTH PLAN, INC.
Subdivision Name
Urban Health Plan at Kips Bay Boys and Girls Club Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH02360T
Entity Address
1930 Randall Ave
Bronx, NY 10473-2608
Grant Number
H80CS00368
Participating Start Date
10/1/2015
Last Recertification Date
2/20/2023
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
STAND PHARMACY
Pharmacy Address
1515 SOUTHERN BLVD
BRONX, NY 10460
Pharmacy Comments
Contract Details
Approval Date
12/6/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Paloma Hernandez, President and CEO
(718) 589-2440 Ext: 4219
Contract Pharmacy Representative
SOL'S 4 PHARMACY INC
Andrew Silverman, President
(718) 639-4107
Signed By Date
12/6/2016
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