Contract Pharmacy Details

BRANAC INC
CH021917C UPPER ROOM AIDS MINISTRY, INC.: ADULT DAY HEALTH CARE CENTER

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

BRANAC INC

Pharmacy Address

CONEY ISLAND PHARMACY
2720 MERMAID AVENUE
BROOKLYN, NY 11224-2006

Pharmacy Comments

Contract Details

Approval Date

4/18/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/8/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Tamisha M McPherson, EXECUTIVE DIRECTOR
(212) 803-2850 Ext: 2444

Contract Pharmacy Representative

Elena Ivanova, Owner
(212) 249-8202

Signed By Date

4/18/2017

340B Drug Pricing Program Database