Contract Pharmacy Details

FARMACIA SUNRAY
FQHCLA365 OSBORN FAMILY HEALTH CENTER, INC., THE

Covered Entity Details

Entity Name

OSBORN FAMILY HEALTH CENTER, INC., THE

Subdivision Name

Osborn Family Health Center

Type

Health Center Program Look-Alike

340B ID

FQHCLA365

Entity Address

1601 Haddon Avenue
Camden, NJ 08103-3109

Grant Number

LALCS31541

Participating Start Date

4/1/2018

Last Recertification Date

1/28/2020

Entity Termination Date

7/1/2020

Pharmacy Details

Pharmacy Name

FARMACIA SUNRAY

Pharmacy Address

2500 FEDERAL ST
CAMDEN, NJ 08105

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

7/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Shawne Cuilla, Executive Director/CEO
(856) 757-3706

Contract Pharmacy Representative

Pharmacist
Robert Siegel, Owner
(856) 963-2900

Signed By Date

4/13/2018

340B Drug Pricing Program Database