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MIDDLETOWN APOTHECARY
CH020620 Cornerstone Family Healthcare
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Covered Entity Details
Entity Name
Cornerstone Family Healthcare
Subdivision Name
Cornerstone Family Healthcare: The Kaplan Family Pavilion
Type
HRSA-Funded Health Center
340B ID
CH020620
Entity Address
147 Lake St
Newburgh, NY 12550
Grant Number
H80CS00469
Participating Start Date
1/1/1999
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MIDDLETOWN APOTHECARY
Pharmacy Address
149 WICKHAM AVE
MIDDLETOWN, NY 10940
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/11/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
LINDA S. MULLER, CEO
(845) 220-3130
Contract Pharmacy Representative
Middletown Apothecary
Gary Stopa, Owner
(845) 342-5566
Signed By Date
4/13/2018
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