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KOO & CO
CH02139B CHARLES B. WANG COMMUNITY HEALTH CENTER, INC.
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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
CH02139B
Entity Address
136-26 37th Ave
Flushing, NY 11354-6533
Grant Number
H80CS00358
Participating Start Date
10/1/2009
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
2/1/2010
Contract Begin Date
2/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANE T. ENG, CEO
(212) 379-6999
Contract Pharmacy Representative
PETER KOO, PRESIDENT
(718) 888-0893
Signed By Date
1/29/2010
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