Contract Pharmacy Details

KOO & CO
CH021390 CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.

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

CH021390

Entity Address

125 Walker St
New York, NY 10013-4135

Grant Number

H80CS00358

Participating Start Date

12/1/1992

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

KOO & CO

Pharmacy Address

13636 39TH AVE
FLUSHING, NY 11354-5599

Pharmacy Comments

Contract Details

Approval Date

1/15/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JANE T. ENG, President & CEO
(212) 379-6988 Ext: 2601

Contract Pharmacy Representative

PETER KOO, PRESIDENT
(718) 888-0893

Signed By Date

1/15/2015

340B Drug Pricing Program Database