Contract Pharmacy Details

NAI SATURN EASTERN LLC
RWI200110 Andromeda Transcultural Health

Covered Entity Details

Entity Name

Andromeda Transcultural Health

Subdivision Name

Type

Ryan White Part A

340B ID

RWI200110

Entity Address

1400 Decatur St. NW
Washington, DC 20011

Grant Number

H89HA00012

Participating Start Date

7/1/2018

Last Recertification Date

2/4/2022

Entity Termination Date

4/1/2023

Pharmacy Details

Pharmacy Name

NAI SATURN EASTERN LLC

Pharmacy Address

DBA SAFEWAY PHARMACY #2808
3830 GEORGIA AVE NW
WASHINGTON, DC 20011

Pharmacy Comments

Contract Details

Approval Date

4/24/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/15/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Ana M Gomez, Practice Manager
(202) 291-4707 Ext: 118

Contract Pharmacy Representative

Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763

Signed By Date

4/16/2018

340B Drug Pricing Program Database