Contract Pharmacy Details

ACME MARKETS INC
RWI19114 Urban Solutions

Covered Entity Details

Entity Name

Urban Solutions

Subdivision Name

Newlands Health

Type

Ryan White Part A

340B ID

RWI19114

Entity Address

9625 Frankford Avenue
Philadelphia, PA 19114

Grant Number

H89HA00013

Participating Start Date

10/1/2017

Last Recertification Date

2/8/2018

Entity Termination Date

8/16/2018

Pharmacy Details

Pharmacy Name

ACME MARKETS INC

Pharmacy Address

SAV-ON PHARMACY #2789
7901 LANSDOWNE AVE
UPPER DARBY, PA 19082

Pharmacy Comments

Contract Details

Approval Date

10/13/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/13/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Simone Peters-Bottos, Board Chair
(267) 528-7335

Contract Pharmacy Representative

Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763

Signed By Date

10/13/2017

340B Drug Pricing Program Database