Contract Pharmacy Details

ACME MARKETS INC
FP191048 African Family Health Organization

Covered Entity Details

Entity Name

African Family Health Organization

Subdivision Name

Type

Family Planning (Title X only)

340B ID

FP191048

Entity Address

4415 Chestnut Street
Suite 202
Philadelphia, PA 19104

Grant Number

FPHPA036073

Participating Start Date

1/1/2016

Last Recertification Date

5/6/2020

Entity Termination Date

7/1/2021

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

10/15/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Oni Richards Waritay, Executive Director
(215) 546-1232

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