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PHARMACY SPECIALIST GROUP III, INC.
CH021980 BROOKLYN PLAZA MEDICAL CENTER
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Covered Entity Details
Entity Name
BROOKLYN PLAZA MEDICAL CENTER
Subdivision Name
BROOKLYN PLAZA MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH021980
Entity Address
650 Fulton St
Brooklyn, NY 11217-1517
Grant Number
H80CS00410
Participating Start Date
9/9/2005
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
PHARMACY SPECIALIST GROUP III, INC.
Pharmacy Address
FAITH PHARMACY
52 WILLOUGHBY ST
BROOKLYN, NY 11201
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/10/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Erroll Byer Jr., CMO
(718) 596-9800 Ext: 251
Contract Pharmacy Representative
Faith Pharmacy
Praveen Challa, Vice President
(718) 643-6300
Signed By Date
1/15/2016
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