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NY88 LLC
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
NY88 LLC
Pharmacy Address
D/B/A MM PHARMACY
5737 MAIN ST
FLUSHING, NY 11355
Pharmacy Comments
Contract Details
Approval Date
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
JANE T. ENG, President & CEO
(212) 379-6988 Ext: 2601
Contract Pharmacy Representative
NY88 LLC
Shanyong Lin, Supervising Pharmacist
(718) 539-8989
Signed By Date
1/10/2020
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