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FINE CARE PHARMACY INC
DSH330396 WOODHULL HOSPITAL CENTER
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Covered Entity Details
Entity Name
WOODHULL HOSPITAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330396
Entity Address
760 BROADWAY
MAIN ENTRANCE: 720 FLUSHING AV
BROOKLYN, NY 11206
Medicare Provider Number
330396
Participating Start Date
12/1/1992
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
FINE CARE PHARMACY INC
Pharmacy Address
981 FULTON STREET
ATTN: SUPERVISING PHARMACIST
BROOKLYN, NY 11238
Pharmacy Comments
Contract Details
Approval Date
10/4/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/17/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
FINE CARE PHARMACY
WAHDAN ABDELAZIN, POINT OF CONTACT
(718) 857-3499
Signed By Date
10/4/2017
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