Covered Entity Details

CH02139B CHARLES B. WANG COMMUNITY HEALTH CENTER, INC. (Active) - information as of 5/13/2025 10:59:36 PM

Main Details

Name

CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.

Subdivision Name

Charles B. Wang Community Health Center, Inc.

Type

HRSA-Funded Health Center

Site ID

BPS-H80-000410

340B ID

CH02139B

Grant Number

H80CS00358

Additional Details

Current Program Status

Active

Registration Date

8/7/2009

Participating Start Date

10/1/2009

Participating Approval Date

9/17/2009

Last Recertification Date

3/3/2025

Contacts

Authorizing Official

Charles B. Wang Community Health Center, Inc.
Kaushal Challa, Chief Executive Officer
(212) 379-6988

Primary Contact

Charles B. Wang Community Health Center, Inc.
Hyoseong Nuna Kim, EVP and Chief Medical Officer
(212) 379-6988

Addresses

Street Address

136-26 37th Ave
Flushing, NY 11354-6533

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	K & F DRUG CORP	4115 KISSENA BLVD		FLUSHING	NY	11355-3138	07/12/2017	10/01/2017		10/01/2017
Contract Detail	KOO & CO	13636 39TH AVE		FLUSHING	NY	11354-5599	02/01/2010	02/01/2010		04/03/2014
Contract Detail	MANHATTAN CHINATOWN PHARMACY INC	D/B/A MCP RX	156 CANAL ST	NEW YORK	NY	10013-4565	04/05/2018	07/01/2018		04/05/2018
Contract Detail	METROPHARM	123 WALKER ST		NEW YORK	NY	10013	01/15/2015	04/01/2015		01/15/2015
Contract Detail	NY88 LLC	D/B/A MM PHARMACY	5737 MAIN ST	FLUSHING	NY	11355	01/10/2020	04/01/2020	12/31/2023	01/04/2024
Contract Detail	PRIMACARE PLUS PHARMACY INC	37-03 MAIN ST		FLUSHING	NY	11354-4106	01/10/2020	04/01/2020		04/01/2020

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH021390	Active	BPS-H80-003386	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	Charles B. Wang Community Health Center, Inc.	125 Walker St	New York	NY
CH02139A	Active	BPS-H80-004662	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	268 Canal St	New York	NY
CH02139B	Active	BPS-H80-000410	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	Charles B. Wang Community Health Center, Inc.	136-26 37th Ave	Flushing	NY
CH02139C	Active	BPS-H80-017275	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	Charles B. Wang Community Health Center, Inc.	137-43 45TH AVE	FLUSHING	NY
CH02139D	Active	BPS-H80-035961	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	Charles B. Wang Community Health Center, Inc.	131-72 40th Road	Flushing	NY

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH021390	K & F DRUG CORP	4115 KISSENA BLVD		FLUSHING	NY	11355-3138	10/01/2017
CH02139A	K & F DRUG CORP	4115 KISSENA BLVD		FLUSHING	NY	11355-3138	10/01/2017
CH02139B	K & F DRUG CORP	4115 KISSENA BLVD		FLUSHING	NY	11355-3138	10/01/2017
CH02139C	K & F DRUG CORP	4115 KISSENA BLVD		FLUSHING	NY	11355-3138	10/01/2017
CH021390	KOO & CO	13636 39TH AVE		FLUSHING	NY	11354-5599	04/01/2015
CH02139A	KOO & CO	13636 39TH AVE		FLUSHING	NY	11354-5599	04/01/2015
CH02139B	KOO & CO	13636 39TH AVE		FLUSHING	NY	11354-5599	02/01/2010
CH02139C	KOO & CO	13636 39TH AVE		FLUSHING	NY	11354-5599	04/01/2016
CH021390	MANHATTAN CHINATOWN PHARMACY INC	D/B/A MCP RX	156 CANAL ST	NEW YORK	NY	10013-4565	07/01/2018
CH02139A	MANHATTAN CHINATOWN PHARMACY INC	D/B/A MCP RX	156 CANAL ST	NEW YORK	NY	10013-4565	07/01/2018
CH02139B	MANHATTAN CHINATOWN PHARMACY INC	D/B/A MCP RX	156 CANAL ST	NEW YORK	NY	10013-4565	07/01/2018
CH02139C	MANHATTAN CHINATOWN PHARMACY INC	D/B/A MCP RX	156 CANAL ST	NEW YORK	NY	10013-4565	07/01/2018
CH021390	METROPHARM	123 WALKER ST		NEW YORK	NY	10013	02/01/2010
CH02139A	METROPHARM	123 WALKER ST		NEW YORK	NY	10013	02/01/2010
CH02139B	METROPHARM	123 WALKER ST		NEW YORK	NY	10013	04/01/2015
CH02139C	METROPHARM	123 WALKER ST		NEW YORK	NY	10013	04/01/2016
CH02139A	NY88 LLC	D/B/A MM PHARMACY	5737 MAIN ST	FLUSHING	NY	11355	04/01/2020	12/31/2023
CH021390	NY88 LLC	D/B/A MM PHARMACY	5737 MAIN ST	FLUSHING	NY	11355	04/01/2020	12/31/2023
CH02139B	NY88 LLC	D/B/A MM PHARMACY	5737 MAIN ST	FLUSHING	NY	11355	04/01/2020	12/31/2023
CH02139C	NY88 LLC	D/B/A MM PHARMACY	5737 MAIN ST	FLUSHING	NY	11355	04/01/2020	12/31/2023
CH02139A	PRIMACARE PLUS PHARMACY INC	37-03 MAIN ST		FLUSHING	NY	11354-4106	04/01/2020
CH021390	PRIMACARE PLUS PHARMACY INC	37-03 MAIN ST		FLUSHING	NY	11354-4106	04/01/2020
CH02139B	PRIMACARE PLUS PHARMACY INC	37-03 MAIN ST		FLUSHING	NY	11354-4106	04/01/2020
CH02139C	PRIMACARE PLUS PHARMACY INC	37-03 MAIN ST		FLUSHING	NY	11354-4106	04/01/2020

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Recertification	PONG, PERRY EVP & CMO Charles B. Wang Community Health Center, Inc. 2123796999-2323	Kim, Hyoseong Nuna EVP and Chief Medical Officer Charles B. Wang Community Health Center, Inc. 2123796988	3/3/2025 12:47 PM
Details	Last Recertification Date	Update	Recertification	1/29/2024 4:18:36 PM	3/3/2025 12:47:31 PM	3/3/2025 12:47 PM
Details	Last Recertification Date	Update	Recertification	2/1/2023 12:28:12 PM	1/29/2024 4:18:36 PM	1/29/2024 4:18 PM
Details	Last Recertification Date	Update	Recertification	2/4/2022 12:00:03 PM	2/1/2023 12:28:12 PM	2/1/2023 12:28 PM
Details	Last Recertification Date	Update	Recertification	2/3/2021 1:26:17 PM	2/4/2022 12:00:03 PM	2/4/2022 12:00 PM
Details	Last Recertification Date	Update	Recertification	1/28/2020 11:27:16 AM	2/3/2021 1:26:17 PM	2/3/2021 1:26 PM
Contacts	Authorizing Official	Update	AO Change Request	ENG, JANE T. President & CEO Charles B. Wang Community Health Center, Inc. 2123796988-2601	Challa, Kaushal Chief Executive Officer Charles B. Wang Community Health Center, Inc. 2123796988	2/3/2021 12:47 PM
Details	Last Recertification Date	Update	Recertification	1/31/2019 2:18:44 PM	1/28/2020 11:27:16 AM	1/28/2020 11:27 AM
Addresses	Main Address	Update	Recertification	13626 37th Ave Flushing, NY 11354-6533	136-26 37th Ave Flushing, NY 11354-6533	1/31/2019 2:18 PM
Details	Last Recertification Date	Update	Recertification	2/12/2018 1:40:33 PM	1/31/2019 2:18:44 PM	1/31/2019 2:18 PM
Details	Last Recertification Date	Update	Recertification	2/2/2017 12:00:00 AM	2/12/2018 1:40:33 PM	2/12/2018 1:40 PM
Contacts	Primary Contact	Update	Recertification	PONG, PERRY CMO 2123796999-2323	PONG, PERRY EVP & CMO Charles B. Wang Community Health Center, Inc. 2123796999-2323	2/12/2018 1:32 PM
Contacts	Authorizing Official	Update	Profile Change Request	ENG, JANE T. CEO Charles B. Wang Community Health Center, Inc. 2123796988-2601	ENG, JANE T. President & CEO Charles B. Wang Community Health Center, Inc. 2123796988-2601	2/12/2018 1:18 PM
Contacts	Authorizing Official	Update		ENG, JANE T. CEO 2123796988-2601	ENG, JANE T. CEO Charles B. Wang Community Health Center, Inc. 2123796988-2601	2/12/2018 1:12 PM
Contacts	Authorizing Official	Insert			ENG, JANE T. CEO 2123796988-2601	7/12/2017 4:50 PM
Contacts	Primary Contact	Insert			PONG, PERRY CMO 2123796999-2323	6/21/2017 11:07 AM
Addresses	Main Address	Insert			13626 37th Ave Flushing, NY 11354-6533	2/2/2017 3:36 PM
Details	Last Recertification Date	Update		2/26/2016 12:00:00 AM	2/2/2017 12:00:00 AM	2/2/2017 3:36 PM
Details	Last Recertification Date	Update		1/28/2015 12:00:00 AM	2/26/2016 12:00:00 AM	2/26/2016 3:14 PM
Details	Last Recertification Date	Update		3/19/2014 12:00:00 AM	1/28/2015 12:00:00 AM	1/28/2015 9:40 AM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	3/19/2014 12:00:00 AM	3/19/2014 6:56 AM
Details	Entity Name	Update		CHARLES B. WANG COMMUNITY HEALTH CENTER	CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.	3/19/2014 6:56 AM
Details	Entity Subname	Update			Charles B. Wang Community Health Center, Inc.	3/19/2014 6:56 AM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	2/7/2013 1:52 PM
Details	Last Recertification Date	Insert				9/17/2009 8:15 AM
Details	Grant Number	Insert			H80CS00358	9/17/2009 8:15 AM
Details	340B ID	Insert			CH02139B	9/17/2009 8:15 AM
Details	Is Authorizing Official EHB Data	Insert				9/17/2009 8:15 AM
Dates	Last Date That 340B Drugs Purchased	Insert				9/17/2009 8:15 AM
Details	Medicare Provider Number	Insert				9/17/2009 8:15 AM
Details	Entity Name	Insert			CHARLES B. WANG COMMUNITY HEALTH CENTER	9/17/2009 8:15 AM
Details	Program Code	Insert			CH	9/17/2009 8:15 AM
Details	Entity Subname	Insert				9/17/2009 8:15 AM
Dates	Participating Approval Date	Insert			9/17/2009 12:00:00 AM	9/17/2009 8:15 AM
Details	State	Insert			Active	9/17/2009 8:15 AM
Dates	Registration Date	Insert			8/7/2009 12:00:00 AM	9/17/2009 8:15 AM
Dates	Signed By Date	Insert			6/29/2009 12:00:00 AM	9/17/2009 8:15 AM
Dates	Start Date	Insert			10/1/2009 12:00:00 AM	9/17/2009 8:15 AM
Terminations	Termination Comments	Insert				9/17/2009 8:15 AM
Terminations	Termination Date	Insert				9/17/2009 8:15 AM
Terminations	Termination Effective Date	Insert				9/17/2009 8:15 AM
Terminations	Termination Reason	Insert				9/17/2009 8:15 AM

340B Drug Pricing Program Database