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WATSONS PHARMACY LLC
CHC22680-00 HEALTHCARE CHOICES NY, INC.
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Covered Entity Details
Entity Name
HEALTHCARE CHOICES NY, INC.
Subdivision Name
HealthCare Choices NY, Inc. - Brooklyn
Type
HRSA-Funded Health Center
340B ID
CHC22680-00
Entity Address
6209 16th Ave
Brooklyn, NY 11204-2702
Grant Number
H80CS22680
Participating Start Date
7/1/2012
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WATSONS PHARMACY LLC
Pharmacy Address
192-21 STATION RD
FLUSHING, NY 11358-2956
Pharmacy Comments
Contract Details
Approval Date
7/18/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/20/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Maria Siebel, CEO
(718) 234-0073 Ext: 26003
Contract Pharmacy Representative
Watson Pharmacy
Jerry Louie, Owner
(718) 359-1188
Signed By Date
7/18/2018
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