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HEALTHONE PHARMACY, INC
FQHCLA334U NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
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Covered Entity Details
Entity Name
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Subdivision Name
East New York Diagnostic and Treatment Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA334U
Entity Address
2094 Pitkin Ave
Brooklyn, NY 11207-3509
Grant Number
LALCS00169
Participating Start Date
7/1/2015
Last Recertification Date
2/22/2018
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
HEALTHONE PHARMACY, INC
Pharmacy Address
119 PENNSYLVANIA AVE
BROOKLYN, NY 11207-2993
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/21/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Healthone
Mel Springer, Owner
(718) 495-9015
Signed By Date
10/12/2017
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