2023-11-03T10:38:35-05:00 2022-12-31 135565207 KPMG LLP 345 PARK AVENUE NEW YORK NY 101540102 990PF 2022-01-01 261437283 PFIZER PATIENT ASSISTANCE FOUNDATION INC PFIZ 2127332323 235 EAST 42ND STREET NEW YORK NY 10017 NIESHA FOSTER EXECUTIVE DIRECTOR 2127332323 2023-11-03 1 NIESHA FOSTER 999009999 0 OMO-OSE JOSEPH-ERAMEH P02534927 2127589700 2023-11-03 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X 8081146 X 1970128470 0 0 1970128470 0 0 0 0 0 0 4259 0 0 4259 27694686 0 0 27694686 15750 0 0 15750 27714695 0 0 27714695 1964055275 1964055275 1991769970 0 0 1991769970 -21641500 0 0 3150722 2293352 2293352 27648599 5787794 5787794 30799321 8081146 8081146 14760179 13683504 14760179 13683504 X 0 0 0 0 16039142 -5602358 16039142 -5602358 30799321 8081146 16039142 -21641500 0 -5602358 0 -5602358 0 0 0 0 0 0 0 0 0 0 0 0 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 2127330413 235 EAST 42ND STREET NEW YORK NY 10017 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CAROLINE ROAN 235 EAST 42ND STREET NEW YORK NY 10017 CHAIRPERSON 29.00 0 0 0 NIESHA FOSTER 235 EAST 42ND STREET NEW YORK NY 10017 EXECUTIVE DIRECTOR 32.00 0 0 0 PATRICK CAUBEL 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR 1.00 0 0 0 BEATRICE FARO 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR UNTIL 9/2022 1.00 0 0 0 DEBBIE WALTERS-FRANCIQUE 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR 1.00 0 0 0 BERT BRUCE 500 ARCOLA ROAD COLLEGEVILLE PA 19426 DIRECTOR 1.00 0 0 0 DIEGO SACRISTAN 235 EAST 42ND STREET NEW YORK NY 10017 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 235 EAST 42ND STREET NEW YORK NY 10017 TREASURER 1.00 0 0 0 JIM SAGE 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR UNTIL 9/2022 1.00 0 0 0 RADIFE KIRAL DEVELIOGLU 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR UNTIL 11/2022 1.00 0 0 0 RODRIGO PUGA 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR AS OF 12/2022 1.00 0 0 0 LESLIE KOBY 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR AS OF 12/2022 1.00 0 0 0 JOYL SILVA 235 EAST 42ND STREET NEW YORK NY 10017 DIRECTOR AS OF 12/2022 1.00 0 0 0 NONE 0 LASH GROUP 1800 INNOVATION POINT FORT MILL SC 29715 PROG ADMINISTRATION 16349943 SONEXUS HEALTH LLC 2730 S EDMONDS LANE SUITE 300 LEWISVILLE TX 75067 PROG ADMINISTRATION 6930230 CONDUENT COMMERCIAL SOLUTIONS LLC 500 ATRIUM DRIVE SOMERSET NJ 08873 PROG ADMINISTRATION 3625651 AMERIPHARM INC 2503 EAST 54TH STREET NORTH SIOUX FALLS SD 571045563 PROG ADMINISTRATION 3198873 PRICEWATERHOUSE COOPERS LLP PO BOX 905615 CHARLOTTE NC 282905615 PROG ADMINISTRATION 390700 0 INDIVIDUAL PATIENT PROGRAMS 1962485012 INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1570263 0 0 3763222 0 3763222 0 0 3763222 56448 3706774 185339 X 1991769970 0 1991769970 2008-03-24 X 0 498 0 0 498 0 423 0 0 423 1991769970 1613631295 1415786090 1120881038 6142068393 1570263 1683398 10010178 17747922 31011761 1990199707 1611947897 1405775912 1103133116 6111056632 0 0 123559 109984 77605 180783 491931 0 0 0 0 PFIZER PATIENT ASSISTANCE PROGRAM 235 E 42ND STREET NEW YORK NY 10017 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. ACRES HOME PHARMACY 818 RINGOLD STREET HOUSTON TX 77088 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 11264 ALDINE PHARMACY 4755 ALDINE MAIL ROUTE HOUSTON TX 77039 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 9860 ANDERSON FREE CLINIC 414 NORTH FANT STREET ANDERSON SC 29621 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2994 ARLINGTON FREE CLINIC 2921 SOUTH 11TH STREET ARLINGTON VA 22204 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1820 BAYTOWN PHARMACY 1602 GARTH ROAD BAYTOWN TX 77520 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 5910 BRADLEY FREE CLINIC 1240 THIRD STREET SW ROANOKE VA 24016 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 4107 CAPE FEAR CLINIC INC 1607 DOCTORS CIRCLE WILMINGTON NC 28401 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 9527 CASA DE AMIGOS PHARMACY 1615 NORTH MAIN STREET HOUSTON TX 28401 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 5357 CENLA MEDICATION ACCESS PROGRAM (CMAP) 1101 4TH ST STE 203B ALEXANDRIA LA 71301 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 9334 CHARITABLE PHARMACY OF NORTH TEXAS INC DBA ST VINCENT DEPAUL PHARMACY 5750 PINELAND DR SUITE 280 DALLAS TX 75231 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 7807 COMMUNITYHEALTH MEDACCESS CHICAGO 2611 WEST CHICAGO AVENUE CHICAGO IL 60622 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 30795 CROSSOVER HEALTH MINISTRY 108 COWARDIN AVE RICHMOND VA 23224 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 6434 E A SQUATTY LYONS PHARMACY 1712 FIRST STREET SUITE M20 HUMBLE TX 77338 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 6400 EL FRANCO LEE PHARMACY 8901 BOONE ROAD HOUSTON TX 77099 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 10816 FONDREN FOUNDATION LAB AT SMITH SMITH PHARMACY 2525-A HOLLY HALL STREET HOUSTON TX 77054 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 4592 GATEWAY COMMUNITY HEALTH CENTER 1515 PAPPAS ST LAREDO TX 78041 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 376 GRADY MEMORIAL HOSPITAL 80 JESSE HILL JR DR ATLANTA GA 30303 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 8948 GREENVILLE FREE MEDICAL CLINIC 600 ARLINGTON AVE GREENVILLE SC 29601 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 35266 GUADALUPE CLINIC 940 S SAINT FRANCIS ST WICHITA KS 22443 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 10709 GUADALUPE FREE CLINIC 700 MCKINNEY BLVD COLONIAL BEACH VA 22443 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 188 GULFFATE PHARMACY 7550 OFFICE CITY DRIVE HOUSTON TX 77012 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 6588 HEALTH AND HOPE CLINIC INC 1718 EAST OLIVE RD PENSACOLA FL 32514 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 11671 KINTEGRA FAMILY MEDICINE - LINCOLNTON 212 GAMBLE DR LINCOLNTON NC 28092 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 87 LACKEY FREE FAMILY MEDICINE CLINIC 1620 OLD WILLIAMSBURG ROAD YORKTOWN VA 23690 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 23311 LBJ HOSPITAL OUTPATIENT PHARMACY 5656 KELLEY STREET HOUSTON TX 77026 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 4706 LLOYD F MOSS FREE CLINIC 1301 SAM PERRY BLVD SUITE 100 FREDERICKSBURG VA 22401 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 19177 MALTA HOUSE OF CARE CLINIC 134 FARMINGTON AVE HARTFORD CT 06105 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 6850 MBCHC-2- BEVERLY PRESS CENTER 1221-71ST STREET MIAMI BEACH FL 33141 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 101 MEMORIAL REGIONAL HOSPITAL 3501 JOHNSON STREET HOLLYWOOD FL 33021 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1606 MEMORIAL REGIONAL HOSPITAL PRIMARY CARE CENTERS 4105 PEMBROKE ROAD HOLLYWOOD FL 33021 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 10090 MERCI CLINIC INC 1315 TATUM DRIVE NEW BERN NC 28560 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 26939 MIAMI BEACH COMMUNITY HEALTH CENTER 4 11645 BISCAYNE BLVD SUITE 102 NORTH MIAMI FL 33181 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 233 MLK PHARMACY 3525 SWINGLE ROAD HOUSTON TX 77047 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 3475 MOUNTAIN CARE CENTER 8252 RIVERSIDE DRIVE OAKWOOD VA 24631 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2225 NC MEDASSIST 4428 TAGGART CREEK RD STE 101 CHARLOTTE NC 28208 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 147497 NORTHEAST ALABAMA HEALTH SERVICES 309 TAYLOR STREET SCOTTSBORO AL 35768 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1189 NORTHERN NECK FREE CLINIC 51 WILLIAM B GRAHAM COURT KILMARNOCK VA 22482 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 1124 NORTHWEST PHARMACY 1100 WEST 34TH STREET HOUSTON TX 77018 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 9038 PEOPLE'S PHARMACY 6630 DE MOSS STREET HOUSTON TX 77074 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 14714 RXCARE PHARMACY - COMMUNITY MEDICINE 3595 OLENTANGY RIVER RD COLUMBUS OH 43214 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 593 SANTA BARBARA COUNTY HEALTH CARE SRVS 300 N SAN ANTONIO RD SANTA BARBARA CA 931101316 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2883 SETTEGAST PHARMACY 9105 NORTH WAYSIDE DRIVE HOUSTON TX 77028 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 3012 SINCLAIR HEALTH CENTER 301 N CAMERON ST SUITE 100 WINCHESTER VA 22601 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 377 ST VINCENT DE PAUL CHARITABLE PHARMACY 1125 BANK ST CINCINNATI OH 45214 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 2071 ST VINCENT DE PAUL CHARITABLE PHARMACY - GLENHILLS 3015 GLENHILLS WAY CINCINNATI OH 45238 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 376 STRAWBERRY PHARMACY 927 E SHAW ROAD PASADENA TX 77506 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 9412 THE FREE MEDICAL CLINIC 1875 HARDEN ST COLUMBIA SC 29204 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 82587 THOMAS STREET PHARMACY 2015 THOMAS STREET HOUSTON TX 77009 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 753 UNIVERSITY HEALTH TRUMAN MEDICAL CENTER 2301 HOLMES STREET PHARMACY DEPT KANSAS CITY MO 64108 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 36532 UNIVERSITY HEALTH TRUMAN MEDICAL CENTER LAKEWOOD 7900 LEES SUMMIT ROAD KANSAS CITY MO 64139 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 24527 UNIVERSITY MEDICAL CENTER 602 INDIANA AVE LUBBOCK TX 79415 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 12992 UNIVERSITY MEDICAL CENTER OF EL PASO 4815 ALAMEDA AVE EL PASO TX 79905 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 3115 UNIVERSITY OF NORTH CAROLINA HOSPITALS 4400 EMPEROR BLVD SUITE 200 DURHAM NC 27703 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 20295 WELVISTA 121 GREYSTONE BOULEVARD COLUMBIA SC 29210 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 884261 WESTERN TIDEWATER FREE CLINIC 2019 MEADE PARKWAY SUFFOLK VA 23434 PC INSTITUTIONAL PATIENT ASSISTANCE PROGRAM 13352 INDIVIDUAL PATIENT PROGRAMS 235 EAST 42ND STREET NEW YORK NY 10017 NONE I INDIVIDUAL PATIENT PROGRAM PROVIDES FREE PFIZER MEDICINES TO ELIGIBLE PATIENTS 1962485012 1964055275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X X 1 PFIZER INC 235 EAST 42ND STREET NEW YORK NY 10017 1970128470 X X 1 VALUE OF PRODUCT DONATIONS 1964055275 2022-12-31 LEGAL FEES 4259 0 0 4259 PATIENT ASSISTANT PROGRAM 27193331 0 0 27193331 CONSULTANT EXPENSE 501355 0 0 501355 TAX FILING 15750 0 0 15750