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SALAAM PHARMACY INC.
CHC26191-04 Housing Works Health Services III, Inc.
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Covered Entity Details
Entity Name
Housing Works Health Services III, Inc.
Subdivision Name
Kingsboro Men's MICA Shelter
Type
HRSA-Funded Health Center
340B ID
CHC26191-04
Entity Address
681 Clarkson Avenue
Brooklyn, NY 11203
Grant Number
H80CS26191
Participating Start Date
1/1/2018
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
SALAAM PHARMACY INC.
Pharmacy Address
155 CRYSTAL ST
BROOKLYN, NY 11208
Pharmacy Comments
Contract Details
Approval Date
12/11/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/17/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Patricia Troy, SVP, Healthcare Services
(347) 473-7458
Contract Pharmacy Representative
Salaam Pharmacy
Mujjahid Huq, Owner
(718) 484-8157
Signed By Date
12/11/2017
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