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FULL CARE PHARMACY INC
DSH330196 NYC Health + Hospitals/South Brooklyn Health
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Covered Entity Details
Entity Name
NYC Health + Hospitals/South Brooklyn Health
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330196
Entity Address
2601 OCEAN PARKWAY
BROOKLYN, NY 11235
Medicare Provider Number
330196
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
FULL CARE PHARMACY INC
Pharmacy Address
D/B/A COMMUNITY CARE PHARMACY
2913 SURF AVE
BROOKLYN, NY 11224-1705
Pharmacy Comments
Contract Details
Approval Date
1/11/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Fullcare Pharmacy
Rolson Abraham, Owner
(718) 372-5300
Signed By Date
1/11/2022
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