Contract Pharmacy Details

WOODHULL PRESCRIPTION CENTER
FQHCLA334U NEW YORK CITY HEALTH AND HOSPITALS CORPORATION

Covered Entity Details

Entity Name

NEW YORK CITY HEALTH AND HOSPITALS CORPORATION

Subdivision Name

East New York Diagnostic and Treatment Center

Type

Health Center Program Look-Alike

340B ID

FQHCLA334U

Entity Address

2094 Pitkin Ave
Brooklyn, NY 11207-3509

Grant Number

LALCS00169

Participating Start Date

7/1/2015

Last Recertification Date

2/22/2018

Entity Termination Date

4/1/2019

Pharmacy Details

Pharmacy Name

WOODHULL PRESCRIPTION CENTER

Pharmacy Address

WOODHULL RX CENTER
755 FLUSHING AVE
BROOKLYN, NY 11206-4419

Pharmacy Comments

Contract Details

Approval Date

7/16/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/25/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Contract Pharmacy Representative

MARG PHARMACY DBA KATZ DRUG STORE
Tushar Patel, Owner
(718) 599-1309

Signed By Date

7/16/2018

340B Drug Pricing Program Database