340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
GOLD STREET PHARMA INC.
HV021430 CUMBERLAND DIAGNOSTIC & TREATMENT CENTER
Print
Covered Entity Details
Entity Name
CUMBERLAND DIAGNOSTIC & TREATMENT CENTER
Subdivision Name
Type
Ryan White Part C
340B ID
HV021430
Entity Address
100 NORTH PORTLAND AVE.
BROOKLYN, NY 11205
Grant Number
H76HA00023
Participating Start Date
4/1/1998
Last Recertification Date
2/22/2018
Entity Termination Date
10/1/2018
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
4/4/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Nicks Pharmacy
Murali Kothuri, RPh
(718) 855-1990
Signed By Date
4/4/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session