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WZ PREMIUM 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
WZ PREMIUM INC.
Pharmacy Address
DBA WHITMAN PHARMACY
329A MYRTLE AVE
BROOKLYN, NY 11205-3201
Pharmacy Comments
Contract Details
Approval Date
7/20/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nadine Juste-Beckles, Chief Operations Officer
(718) 596-9800 Ext: 226
Contract Pharmacy Representative
Whitman Pharmacy
Cheng Wan Lin, Owner
(718) 938-0816
Signed By Date
7/20/2017
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