Covered Entity Details

CHC49339-00 RUTGERS THE STATE UNIVERSITY OF NEW JERSEY (Active) - information as of 5/27/2025 11:34:25 PM

Main Details

Name

RUTGERS THE STATE UNIVERSITY OF NEW JERSEY

Subdivision Name

Rutgers RWJ Eric B. Chandler Health Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-038345

340B ID

CHC49339-00

Grant Number

H80CS49339

Additional Details

Current Program Status

Active

Registration Date

4/8/2024

Participating Start Date

7/1/2024

Participating Approval Date

4/29/2024

Last Recertification Date

2/17/2025

Contacts

Authorizing Official

Rutgers RWJ Eric B. Chandler Health Center
Sandra Hill, Executive Director
(732) 235-9099

Primary Contact

Rutgers RWJ Eric B. Chandler Health Center
Toby Russell, Program Administrator/COO
(732) 235-6712

Addresses

Street Address

123 Church St
New Brunswick, NJ 08901-2001

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	ULTRACARE PHARMACY	ULTRACARE PHARMACY	272 GEORGE ST	NEW BRUNSWICK	NJ	08901-1314	10/05/2024	01/01/2025	01/01/2025
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06908	20 JERSEY AVE	NEW BRUNSWICK	NJ	08901-2360	07/17/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04544	520 CONVERY BLVD.	PERTH AMBOY	NJ	08861	07/17/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12097	1 ROBERT WOOD JOHNSON PL.	NEW BRUNSWICK	NJ	08901-1928	07/17/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06983	920 HAMILTON ST UNIT B	SOMERSET	NJ	08873	07/17/2024	10/01/2024	10/01/2024
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #09932	81 PLAINFIELD AVE.	EDISON	NJ	08817	07/17/2024	10/01/2024	10/01/2024
Contract Detail	ZAJACS PHARMACY	225 GEORGE ST		NEW BRUNSWICK	NJ	08901-1322	07/17/2024	10/01/2024	10/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC49339-00	Active	BPS-H80-038345	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	Rutgers RWJ Eric B. Chandler Health Center	123 Church St	New Brunswick	NJ
CHC49339-01	Active	BPS-H80-038344	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	Rutgers RWJ Eric B. Chandler Health Center	1000 Somerset St	New Brunswick	NJ
CHC49339-02	Active	BPS-H80-038343	RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	Rutgers RWJ Eric B. Chandler Health Center	277 George St	New Brunswick	NJ

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date
CHC49339-01	ULTRACARE PHARMACY	ULTRACARE PHARMACY	272 GEORGE ST	NEW BRUNSWICK	NJ	08901-1314	01/01/2025
CHC49339-00	ULTRACARE PHARMACY	ULTRACARE PHARMACY	272 GEORGE ST	NEW BRUNSWICK	NJ	08901-1314	01/01/2025
CHC49339-02	ULTRACARE PHARMACY	ULTRACARE PHARMACY	272 GEORGE ST	NEW BRUNSWICK	NJ	08901-1314	01/01/2025
CHC49339-02	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04544	520 CONVERY BLVD.	PERTH AMBOY	NJ	08861	10/01/2024
CHC49339-01	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12097	1 ROBERT WOOD JOHNSON PL.	NEW BRUNSWICK	NJ	08901-1928	10/01/2024
CHC49339-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06908	20 JERSEY AVE	NEW BRUNSWICK	NJ	08901-2360	10/01/2024
CHC49339-01	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06908	20 JERSEY AVE	NEW BRUNSWICK	NJ	08901-2360	10/01/2024
CHC49339-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04544	520 CONVERY BLVD.	PERTH AMBOY	NJ	08861	10/01/2024
CHC49339-02	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06908	20 JERSEY AVE	NEW BRUNSWICK	NJ	08901-2360	10/01/2024
CHC49339-01	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #09932	81 PLAINFIELD AVE.	EDISON	NJ	08817	10/01/2024
CHC49339-02	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06983	920 HAMILTON ST UNIT B	SOMERSET	NJ	08873	10/01/2024
CHC49339-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12097	1 ROBERT WOOD JOHNSON PL.	NEW BRUNSWICK	NJ	08901-1928	10/01/2024
CHC49339-02	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #09932	81 PLAINFIELD AVE.	EDISON	NJ	08817	10/01/2024
CHC49339-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06983	920 HAMILTON ST UNIT B	SOMERSET	NJ	08873	10/01/2024
CHC49339-02	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12097	1 ROBERT WOOD JOHNSON PL.	NEW BRUNSWICK	NJ	08901-1928	10/01/2024
CHC49339-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #09932	81 PLAINFIELD AVE.	EDISON	NJ	08817	10/01/2024
CHC49339-01	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06983	920 HAMILTON ST UNIT B	SOMERSET	NJ	08873	10/01/2024
CHC49339-01	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04544	520 CONVERY BLVD.	PERTH AMBOY	NJ	08861	10/01/2024
CHC49339-01	ZAJACS PHARMACY	225 GEORGE ST		NEW BRUNSWICK	NJ	08901-1322	10/01/2024
CHC49339-00	ZAJACS PHARMACY	225 GEORGE ST		NEW BRUNSWICK	NJ	08901-1322	10/01/2024
CHC49339-02	ZAJACS PHARMACY	225 GEORGE ST		NEW BRUNSWICK	NJ	08901-1322	10/01/2024

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification		2/17/2025 9:54:07 AM	2/17/2025 9:54 AM
Details	State	Update		Approved	Active	7/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Hill, Sandra Executive Director Rutgers RWJ Eric B. Chandler Health Center 7322359099	4/29/2024 1:52 PM
Details	340B ID	Update	New Registration		CHC49339-00	4/29/2024 1:52 PM
Dates	Participating Approval Date	Update	New Registration		4/29/2024 1:52:57 PM	4/29/2024 1:52 PM
Details	State	Update	New Registration	Pending	Approved	4/29/2024 1:52 PM
Dates	Signed By Date	Update	New Registration		4/12/2024 8:03:20 AM	4/29/2024 1:52 PM
Dates	Start Date	Update	New Registration		7/1/2024 12:00:00 AM	4/29/2024 1:52 PM
Addresses	Main Address	Insert	New Registration		123 Church St New Brunswick, NJ 08901-2001	4/8/2024 9:36 AM
Contacts	Authorizing Official	Insert	New Registration		Hill, Sandra Executive Director Rutgers RWJ Eric B. Chandler Health Center 7322359099	4/8/2024 9:36 AM
Contacts	Primary Contact	Insert	New Registration		Russell, Toby Program Administrator/COO Rutgers RWJ Eric B. Chandler Health Center 7322356712	4/8/2024 9:36 AM
Details	Assistance Received From Date	Insert	New Registration			4/8/2024 9:36 AM
Details	Assistance Received To Date	Insert	New Registration			4/8/2024 9:36 AM
Details	Last Recertification Date	Insert	New Registration			4/8/2024 9:36 AM
Details	Grant Number	Insert	New Registration		H80CS49339	4/8/2024 9:36 AM
Details	340B ID	Insert	New Registration			4/8/2024 9:36 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/8/2024 9:36 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/8/2024 9:36 AM
Details	Medicare Provider Number	Insert	New Registration			4/8/2024 9:36 AM
Details	Entity Name	Insert	New Registration		RUTGERS THE STATE UNIVERSITY OF NEW JERSEY	4/8/2024 9:36 AM
Details	NOFO Number	Insert	New Registration			4/8/2024 9:36 AM
Details	Program Code	Insert	New Registration		CH	4/8/2024 9:36 AM
Details	Entity Subname	Insert	New Registration		Rutgers RWJ Eric B. Chandler Health Center	4/8/2024 9:36 AM
Dates	Participating Approval Date	Insert	New Registration			4/8/2024 9:36 AM
Details	State	Insert	New Registration		Pending	4/8/2024 9:36 AM
Dates	Registration Date	Insert	New Registration		4/8/2024 9:36:55 AM	4/8/2024 9:36 AM
Dates	Signed By Date	Insert	New Registration			4/8/2024 9:36 AM
Dates	Start Date	Insert	New Registration			4/8/2024 9:36 AM
Terminations	Termination Comments	Insert	New Registration			4/8/2024 9:36 AM
Terminations	Termination Date	Insert	New Registration			4/8/2024 9:36 AM
Terminations	Termination Effective Date	Insert	New Registration			4/8/2024 9:36 AM
Terminations	Termination Reason	Insert	New Registration			4/8/2024 9:36 AM

340B Drug Pricing Program Database