2024-11-13T15:21:19-06:00 2023-12-31 135565207 KPMG LLP 345 PARK AVENUE NEW YORK NY 101540102 990PF 2023-01-01 261437283 PFIZER PATIENT ASSISTANCE FOUNDATION INC PFIZ 2127332323 66 HUDSON BLVD EAST NEW YORK NY 10001 NIESHA FOSTER EXECUTIVE DIRECTOR 2127332323 2024-11-13 1 0 DEVIN L DUNCAN P01249521 2127589700 2020-11-13 2023 2024-10-15 13:58:12Z X X 6771644 X 2073666749 12443 12443 0 0 2073679192 12443 0 0 0 0 0 1794 0 0 1794 41292366 0 0 41292366 16550 0 0 16550 41310710 0 0 41310710 2040678841 2040678841 2081989551 0 0 2081989551 -8310359 12443 0 2293352 983850 983850 5787794 5787794 5787794 8081146 6771644 6771644 13683504 20684361 13683504 20684361 X 0 0 0 0 -5602358 -13912717 -5602358 -13912717 8081146 6771644 -5602358 -8310359 0 -13912717 0 -13912717 173 0 173 0 173 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 1 1 DE NY 1 1 0 0 0 1 WWW.PFIZERRXPATHWAYS.COM NIESHA FOSTER 2127332323 66 HUDSON BLVD EAST NEW YORK NY 10001 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAROLINE ROAN 66 HUDSON BLVD EAST NEW YORK NY 10001 CHAIRPERSON 29.00 0 0 0 NIESHA FOSTER 66 HUDSON BLVD EAST NEW YORK NY 10001 EXECUTIVE DIRECTOR 32.00 0 0 0 PATRICK CAUBEL 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR 1.00 0 0 0 DEBBIE WALTERS-FRANCIQUE 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR 1.00 0 0 0 BERT BRUCE 500 ARCOLA ROAD COLLEGEVILLE PA 19426 DIRECTOR 1.00 0 0 0 DIEGO SACRISTAN 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR 1.00 0 0 0 JENNIFER WALTON 1275 PENNSYLVANIA AVE NW SUITE 600 WASHINGTON DC 20004 DIRECTOR 1.00 0 0 0 JENICA STROOCK 100 ROUTE 206N PEAPACK NJ 07977 SECRETARY 32.00 0 0 0 MICHAEL READING 66 HUDSON BLVD EAST NEW YORK NY 10001 TREASURER 1.00 0 0 0 RODRIGO PUGA 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR 1.00 0 0 0 LESLIE KOBY 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR 1.00 0 0 0 JOYL SILVA 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR 1.00 0 0 0 MARIA RIVAS 66 HUDSON BLVD EAST NEW YORK NY 10001 DIRECTOR (AS OF 06/2023) 1.00 0 0 0 NONE 0 LASH GROUP 1800 INNOVATION POINT FORT MILL SC 29715 PROG ADMINISTRATION 20990610 SONEXUS HEALTH LLC 2730 S EDMONDS LANE SUITE 300 LEWISVILLE TX 75067 PROG ADMINISTRATION 7263337 CONDUENT COMMERCIAL SOLUTIONS LLC 500 ATRIUM DRIVE SOMERSET NJ 08873 PROG ADMINISTRATION 3362183 MEDVANTX INC 2503 EAST 54TH STREET NORTH SIOUX FALLS SD 57104 PROG ADMINISTRATION 1623972 ASSISTRX 2001 SUMMIT PARK DR SUITE 700 ORLANDO FL 32810 PROG ADMINISTRATION 1548961 3 INDIVIDUAL PATIENT PROGRAMS 2040263189 INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 412482 0 0 3755372 0 3755372 0 0 3755372 56331 3699041 184952 X 2081989551 0 2081989551 2008-03-24 X 0 0 498 0 498 0 0 423 0 423 2081989551 1991769970 1613631295 1415786090 7103176906 412482 1570263 1683398 10010178 13676321 2081577069 1990199707 1611947897 1405775912 7089500585 0 0 123301 123559 109984 77605 434449 0 0 0 0 PFIZER PATIENT ASSISTANCE PROGRAM 66 HUDSON BLVD EAST NEW YORK NY 10001 8449897284 TO BE EVALUATED FOR ASSISTANCE, PATIENTS AND THEIR HEALTHCARE PROVIDERS MUST SUBMIT A COMPLETED ENROLLMENT FORM. PATIENTS MUST ALSO PROVIDE PROOF OF INCOME, SUCH AS A W2 FORM, A PAYCHECK STUB, OR PRIOR YEAR'S TAX RETURN. IN SOME CASES, PATIENTS PRESCRIBED CERTAIN PFIZER MEDICINES MAY FIRST BE REQUIRED TO SEEK ALTERNATE FORMS OF ASSISTANCE BEFORE THEY CAN BE CONSIDERED FOR FREE MEDICINE THROUGH THE PFIZER PATIENT ASSISTANCE PROGRAM. NONE TO QUALIFY, PATIENTS MUST HAVE A VALID PRESCRIPTION FOR THE PFIZER MEDICINE, AVAILABLE IN THE PAP, FOR WHICH THEY ARE SEEKING ASSISTANCE; HAVE AN FDA-APPROVED INDICATION FOR THE REQUESTED PRODUCT(S); BE UNINSURED OR GOVERNMENT INSURED AND UNABLE TO AFFORD THEIR COPAYMENT; MEET INCOME GUIDELINES, WHICH VARY BY MEDICINE, BUT START AT 300% OF THE FEDERAL POVERTY LEVEL, ADJUSTED FOR FAMILY SIZE; RESIDE IN THE U.S. OR A U.S. TERRITORY; AND BE TREATED BY A HEALTHCARE PROVIDER LICENSED IN THE U.S. OR A U.S. TERRITORY. COMMERCIALLY INSURED PATIENTS ARE NOT ELIGIBLE. ANDERSON FREE CLINIC 414 NORTH FANT STREET ANDERSON SC 29621 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2195 ARLINGTON FREE CLINIC 2921 SOUTH 11TH STREET ARLINGTON VA 22204 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2287 BRADLEY FREE CLINIC 1240 THIRD STREET SW ROANOKE VA 24016 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2935 CAPE FEAR CLINIC INC 1607 DOCTORS CIRCLE WILMINGTON NC 28401 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 4927 CENLA MEDICATION ACCESS PROGRAM (CMAP) 1101 4TH ST STE 203B ALEXANDRIA LA 71301 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 3327 CHARITABLE PHARMACY OF NORTH TEXAS INC DBA ST VINCENT DEPAUL PHARMACY 5750 PINELAND DR SUITE 280 DALLAS TX 75231 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 5103 COMMUNITYHEALTH MEDACCESS CHICAGO 2611 WEST CHICAGO AVENUE CHICAGO IL 60622 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 24743 CROSSOVER HEALTH MINISTRY 108 COWARDIN AVE RICHMOND VA 23224 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 5878 GRADY MEMORIAL HOSPITAL 80 JESSE HILL JR DR ATLANTA GA 30303 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 128410 GREENVILLE FREE MEDICAL CLINIC 600 ARLINGTON AVE GREENVILLE SC 29601 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 18557 GUADALUPE CLINIC 940 S SAINT FRANCIS ST WICHITA KS 22443 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 16744 GUADALUPE FREE CLINIC 700 MCKINNEY BLVD COLONIAL BEACH VA 22443 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1761 LACKEY FREE FAMILY MEDICINE CLINIC 1620 OLD WILLIAMSBURG ROAD YORKTOWN VA 23690 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 4052 LLOYD F MOSS FREE CLINIC 1301 SAM PERRY BLVD SUITE 100 FREDERICKSBURG VA 22401 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 11117 MALTA HOUSE OF CARE CLINIC 134 FARMINGTON AVE HARTFORD CT 06105 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 10996 MERCI CLINIC INC 1315 TATUM DRIVE NEW BERN NC 28560 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2185 MOUNTAIN CARE CENTER 8252 RIVERSIDE DRIVE OAKWOOD VA 24631 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1262 NC MEDASSIST 4428 TAGGART CREEK RD STE 101 CHARLOTTE NC 28208 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 54739 NORTHERN NECK FREE CLINIC 51 WILLIAM B GRAHAM COURT KILMARNOCK VA 22482 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 196 SANTA BARBARA COUNTY HEALTH CARE SRVS 300 N SAN ANTONIO RD SANTA BARBARA CA 931101316 GOV INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 978 SINCLAIR HEALTH CENTER 301 N CAMERON ST SUITE 100 WINCHESTER VA 22601 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 3557 ST VINCENT DE PAUL CHARITABLE PHARMACY 1125 BANK ST CINCINNATI OH 45214 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1556 ST VINCENT DE PAUL CHARITABLE PHARMACY - GLENHILLS 3015 GLENHILLS WAY CINCINNATI OH 45238 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 587 ST VINCENT DEPAUL DBA VIRGINIA B ANDES COMMUNITY PHARMACY 21297 OLEAN BLVD PORT CHARLOTTE FL 33952 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1134 THE FREE MEDICAL CLINIC 1875 HARDEN ST COLUMBIA SC 29204 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 3218 UNIVERSITY HEALTH TRUMAN MEDICAL CENTER 2301 HOLMES STREET PHARMACY DEPT KANSAS CITY MO 64108 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 789 UNIVERSITY HEALTH TRUMAN MEDICAL CENTER LAKEWOOD 7900 LEES SUMMIT ROAD KANSAS CITY MO 64139 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 391 UNIVERSITY MEDICAL CENTER 602 INDIANA AVE LUBBOCK TX 79415 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 8398 UNIVERSITY MEDICAL CENTER OF EL PASO 4815 ALAMEDA AVE EL PASO TX 79905 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 593 UNIVERSITY OF NORTH CAROLINA HOSPITALS 4400 EMPEROR BLVD SUITE 200 DURHAM NC 27703 GOV INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 15879 WELVISTA 121 GREYSTONE BOULEVARD COLUMBIA SC 29210 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 73402 WESTERN TIDEWATER FREE CLINIC 2019 MEADE PARKWAY SUFFOLK VA 23434 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 587 INDIVIDUAL PATIENT PROGRAMS 66 HUDSON BLVD EAST NEW YORK NY 10001 NONE I INDIVIDUAL PATIENT PROGRAM PROVIDES FREE PFIZER MEDICINES TO ELIGIBLE PATIENTS 2040266358 2040678841 0 14 12443 0 12443 0 12443 0 0 0 0 0 0 0 0 0 0 X X 1 PFIZER INC 235 EAST 42ND STREET NEW YORK NY 10017 2073666749 X X 1 VALUE OF PRODUCT DONATIONS 2040678841 2023-12-31 LEGAL FEES 1794 0 0 1794 PROGRAM ADMINISTRATION 41292366 0 0 41292366 TAX FILING 16550 0 0 16550