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GOLD STREET PHARMA INC.
CH02371AG INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
Family Health Center of Harlem
Type
HRSA-Funded Health Center
340B ID
CH02371AG
Entity Address
1824 Madison Ave
New York, NY 10035-3832
Grant Number
H80CS00768
Participating Start Date
10/1/2010
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
GOLD STREET PHARMA INC.
Pharmacy Address
NICK'S PHARMACY
111 GOLD ST
BROOKLYN, NY 11201
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alan Woghin, VP of FInance and CFO
(212) 633-0815 Ext: 1410
Contract Pharmacy Representative
Gold Street Pharma Inc.
Ravi K. Chenna, President
(646) 425-4405
Signed By Date
10/16/2017
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