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PREMIER ONE PHARMACY INC
CH02062S CORNERSTONE FAMILY HEALTHCARE
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Covered Entity Details
Entity Name
CORNERSTONE FAMILY HEALTHCARE
Subdivision Name
Cornerstone Family Healthcare at Middletown
Type
HRSA-Funded Health Center
340B ID
CH02062S
Entity Address
10 Benton Ave
Middletown, NY 10940-5177
Grant Number
H80CS00469
Participating Start Date
1/1/2018
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
PREMIER ONE PHARMACY INC
Pharmacy Address
DBA PREMIUM PHARMACY
4112A MAIN ST
FL 1
FLUSHING, NY 11355
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
LINDA S. MULLER, CEO
(845) 220-3130
Contract Pharmacy Representative
Good Health, Inc
Todd Weber, Director, Government Programs & Strategic Initiatives
(203) 212-4717
Signed By Date
1/12/2018
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