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GREENE RX 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
GREENE RX INC
Pharmacy Address
DBA - GREENE COMMUNITY PHARMACY
702 FULTON ST
BROOKLYN, NY 11217
Pharmacy Comments
Contract Details
Approval Date
12/5/2024
Contract Begin Date
12/12/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Daniel Desire, Chief Financial Officer
(718) 596-9800 Ext: 226
Contract Pharmacy Representative
Greene Community Pharmacy
Shivangi Patel, Pharmacy Manager
(978) 758-5849
Signed By Date
12/5/2024
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