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1875 LEXINGTON AVENUE CORP OF NEW YORK
CH021917C UPPER ROOM AIDS MINISTRY, INC.: ADULT DAY HEALTH CARE CENTER
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Covered Entity Details
Entity Name
UPPER ROOM AIDS MINISTRY, INC.: ADULT DAY HEALTH CARE CENTER
Subdivision Name
The Nest Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH021917C
Entity Address
169 W 133rd St
New York, NY 10030-3301
Grant Number
H80CS17251
Participating Start Date
4/1/2016
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
1875 LEXINGTON AVENUE CORP OF NEW YORK
Pharmacy Address
D/B/A QUICK RX
1875 LEXINGTON AVENUE
NEW YORK, NY 10035-1003
Pharmacy Comments
Contract Details
Approval Date
3/25/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jacquelyn Kilmer, CEO
(212) 803-2886
Contract Pharmacy Representative
Quick Rx Pharmacy Group
Elan Katz, CEO
(917) 733-4301
Signed By Date
3/25/2016
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