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SECOND CENTURY SERVICES CORP
DSH330193A FLUSHING HOSPITAL MEDICAL CENTER
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Covered Entity Details
Entity Name
FLUSHING HOSPITAL MEDICAL CENTER
Subdivision Name
FLUSHING HOSPITAL FACULTY PRACTICE / Maternal Fetal Medicine Clinic
Type
Disproportionate Share Hospital
340B ID
DSH330193A
Entity Address
14601 45th Ave
FLUSHING, NY 11355-2200
Medicare Provider Number
330193
Outpatient Facility Provider Number
Participating Start Date
10/1/2016
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
SECOND CENTURY SERVICES CORP
Pharmacy Address
DBA: FLUSHING RX
146-01 45 AVE
FLUSHING, NY 11355
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MOUNIR F. DOSS, EXECUTIVE VP & CFO
(718) 206-6291
Contract Pharmacy Representative
Second Century Services Corp
waiming wu, pharmacist
(718) 353-3160
Signed By Date
10/12/2018
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