Covered Entity Details

DSH310016 CHRIST HOSPITAL (Active) - information as of 5/2/2025 10:33:57 PM

Main Details

Name

CHRIST HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

Rural

340B ID

DSH310016

Medicare Provider Number

310016

Additional Details

Current Program Status

Active

Registration Date

10/15/2024

Participating Start Date

1/1/2025

Participating Approval Date

11/13/2024

Last Recertification Date

Contacts

Authorizing Official

Hudson Regional Hospital
Angela Murdock-Ridley, VP of Finance, CFO
(718) 930-5259

Primary Contact

Carepoint - Christ Hospital
Vanita Manan, Director of Pharmacy
(201) 423-8060

Addresses

Street Address

176 PALISADES AVENUE
JERSEY CITY, NJ 07306

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	04/15/2025	07/01/2025	04/15/2025
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	04/15/2025	07/01/2025	04/15/2025
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	04/15/2025	07/01/2025	04/15/2025
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	04/15/2025	07/01/2025	04/15/2025
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	04/15/2025	07/01/2025	04/15/2025
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	04/15/2025	07/01/2025	04/15/2025
Contract Detail	BAYONNE HOSPITAL	INPATIENT PHARMACY DEPARTMENT	29 E 29TH ST	BAYONNE	NJ	07002	04/15/2025	07/01/2025	04/15/2025
Contract Detail	BMC PHARMACY		29TH STREET & AVENUE E INSIDE BAYONNE MEDICAL CENTER	BAYONNE	NJ	07002	04/15/2025	07/01/2025	04/15/2025
Contract Detail	BMC PHARMACY	CAREPOINT PHARMACY BAYONNE LLC	29 E 29TH ST	BAYONNE	NJ	07002-4654	04/15/2025	07/01/2025	04/15/2025
Contract Detail	BMC PHARMACY	BCP PHARMACY LLC	573 BROADWAY	BAYONNE	NJ	07002	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/15/2025	07/01/2025	04/15/2025
Contract Detail	CAREPOINT HEALTH PHARMACY	WILLOW AVE PHARMACY LLC	308 WILLOW AVE	HOBOKEN	NJ	07030	04/15/2025	07/01/2025	04/15/2025
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	04/15/2025	07/01/2025	04/15/2025
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	04/15/2025	07/01/2025	04/15/2025
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	04/15/2025	07/01/2025	04/15/2025
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	04/15/2025	07/01/2025	04/15/2025
Contract Detail	INSIGHT CHICAGO, INC	DBA INSIGHT HOSPITAL & MEDICAL CENTER	2525 S MICHIGAN AVE	CHICAGO	IL	60616-2315	04/15/2025	07/01/2025	04/15/2025
Contract Detail	INSIGHT CHICAGO, INC	2525 S MICHIGAN AVE		CHICAGO	IL	60616-2315	04/15/2025	07/01/2025	04/15/2025
Contract Detail	NEW JERSEY CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01928	59 WASHINGTON ST COURT STREET PLAZA	HOBOKEN	NJ	07030	04/15/2025	07/01/2025	04/15/2025
Contract Detail	NEW JERSEY CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 02209	811 CLINTON STREET	HOBOKEN	NJ	07030	04/15/2025	07/01/2025	04/15/2025
Contract Detail	NEW JERSEY CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04443	210 14TH ST.	HOBOKEN	NJ	07030	04/15/2025	07/01/2025	04/15/2025
Contract Detail	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	04/15/2025	07/01/2025	04/15/2025
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	04/15/2025	07/01/2025	04/15/2025
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	04/15/2025	07/01/2025	04/15/2025
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	04/15/2025	07/01/2025	04/15/2025
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	04/15/2025	07/01/2025	04/15/2025
Contract Detail	RARE SPECIALTY PHARMACY	398 W GRAND AVE		RAHWAY	NJ	07065	04/15/2025	07/01/2025	04/15/2025

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
No records to display.

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Change Request	Hughes, David Chief Pharmacy Officer Carepoint Health 4012491963	Murdock-Ridley, Angela VP of Finance, CFO Hudson Regional Hospital 7189305259	4/2/2025 8:25 AM
Details	State	Update		Approved	Active	1/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Hughes, David Chief Pharmacy Officer Carepoint Health 4012491963	11/13/2024 2:11 PM
Details	340B ID	Update	New Registration		DSH310016	11/13/2024 2:11 PM
Dates	Participating Approval Date	Update	New Registration		11/13/2024 2:11:12 PM	11/13/2024 2:11 PM
Details	State	Update	New Registration	Pending	Approved	11/13/2024 2:11 PM
Dates	Signed By Date	Update	New Registration		10/30/2024 3:28:53 PM	11/13/2024 2:11 PM
Dates	Start Date	Update	New Registration		1/1/2025 12:00:00 AM	11/13/2024 2:11 PM
Addresses	Main Address	Insert	New Registration		176 PALISADES AVENUE JERSEY CITY, NJ 07306	10/15/2024 9:42 AM
Contacts	Authorizing Official	Insert	New Registration		Hughes, David Chief Pharmacy Officer Carepoint Health 4012491963	10/15/2024 9:42 AM
Contacts	Primary Contact	Insert	New Registration		Manan, Vanita Director of Pharmacy Carepoint - Christ Hospital 2014238060	10/15/2024 9:42 AM
Details	Assistance Received From Date	Insert	New Registration			10/15/2024 9:42 AM
Details	Assistance Received To Date	Insert	New Registration			10/15/2024 9:42 AM
Details	Last Recertification Date	Insert	New Registration			10/15/2024 9:42 AM
Details	Grant Number	Insert	New Registration			10/15/2024 9:42 AM
Details	340B ID	Insert	New Registration			10/15/2024 9:42 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/15/2024 9:42 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/15/2024 9:42 AM
Details	Medicare Provider Number	Insert	New Registration		310016	10/15/2024 9:42 AM
Details	Entity Name	Insert	New Registration		CHRIST HOSPITAL	10/15/2024 9:42 AM
Details	NOFO Number	Insert	New Registration			10/15/2024 9:42 AM
Details	Program Code	Insert	New Registration		DSH	10/15/2024 9:42 AM
Details	Entity Subname	Insert	New Registration			10/15/2024 9:42 AM
Dates	Participating Approval Date	Insert	New Registration			10/15/2024 9:42 AM
Details	State	Insert	New Registration		Pending	10/15/2024 9:42 AM
Dates	Registration Date	Insert	New Registration		10/15/2024 9:42:44 AM	10/15/2024 9:42 AM
Dates	Signed By Date	Insert	New Registration			10/15/2024 9:42 AM
Dates	Start Date	Insert	New Registration			10/15/2024 9:42 AM
Terminations	Termination Comments	Insert	New Registration			10/15/2024 9:42 AM
Terminations	Termination Date	Insert	New Registration			10/15/2024 9:42 AM
Terminations	Termination Effective Date	Insert	New Registration			10/15/2024 9:42 AM
Terminations	Termination Reason	Insert	New Registration			10/15/2024 9:42 AM