Contract Pharmacy Details

SUNRAY DRUGS PROGRESS PLAZA
RWI19107B ActionAIDS dba Action Wellness

Covered Entity Details

Entity Name

ActionAIDS dba Action Wellness

Subdivision Name

Action Wellness

Type

Ryan White Part A

340B ID

RWI19107B

Entity Address

Action Wellness
401 Avenue of the States, Suite 2
Chester, PA 19013

Grant Number

H89HA00013

Participating Start Date

4/1/2018

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

SUNRAY DRUGS PROGRESS PLAZA

Pharmacy Address

1501 N BROAD ST STE 9
PHILADELPHIA, PA 19122

Pharmacy Comments

Contract Details

Approval Date

4/12/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kevin J. Burns, Executive Director
(215) 981-3338

Contract Pharmacy Representative

Sun Ray Drugs 60th Street
Nick Shaiko, Pharmacy Manager
(215) 474-4550

Signed By Date

4/12/2018

340B Drug Pricing Program Database