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KOO & CO
CH02139A CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.
Subdivision Name
CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH02139A
Entity Address
268 Canal St
New York, NY 10013-3599
Grant Number
H80CS00358
Participating Start Date
7/1/2002
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
KOO & CO
Pharmacy Address
13636 39TH AVE
FLUSHING, NY 11354-5599
Pharmacy Comments
Contract Details
Approval Date
1/15/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANE T. ENG, President & CEO
(212) 379-6988 Ext: 2601
Contract Pharmacy Representative
PETER KOO, PRESIDENT
(718) 888-0893
Signed By Date
1/15/2015
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