Covered Entity Details

CH024490 NORTH HUDSON COMMUNITY ACTION CORPORATION (Active) - information as of 5/23/2025 12:03:57 AM

Main Details

Name

NORTH HUDSON COMMUNITY ACTION CORPORATION

Subdivision Name

North Hudson Community Action Corporation @ West New York

Type

HRSA-Funded Health Center

Site ID

BPS-H80-001173

340B ID

CH024490

Grant Number

H80CS00521

Additional Details

Current Program Status

Active

Registration Date

1/1/2004

Participating Start Date

1/1/2004

Participating Approval Date

2/26/2004

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

North Hudson Community Action Corporation
Rebecca Acosta, Executive Vice President
(201) 210-0100 Ext: 10102

Primary Contact

FQHC
Amanda Martinez, Executive Assistant to EVP; 340B Manager
(201) 494-3873

Addresses

Street Address

5301 BROADWAY
WEST NEW YORK, NJ 07093-2622

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?
Yes

State	Medicaid Number	NPI Number
NJ	0022705

Shipping Addresses

Shipping Address 1

North Hudson Community Action Corporation
800 31st Street
Union City, NJ 07087

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/17/2024	01/01/2025		01/01/2025
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/17/2024	01/01/2025		01/01/2025
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/17/2024	01/01/2025		01/01/2025
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/17/2024	01/01/2025		01/01/2025
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/17/2024	01/01/2025		01/01/2025
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	10/17/2024	01/01/2025		01/01/2025
Contract Detail	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	01/08/2019	04/01/2019	10/13/2021	10/14/2021
Contract Detail	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	04/15/2018	07/01/2018		04/15/2018
Contract Detail	AMERICA'S PHARMACY	1500 SUMMIT AVE.		UNION CITY	NJ	07087-1919	07/11/2014	10/01/2014	07/08/2015	07/28/2015
Contract Detail	ANTHONY'S PHARMACY		4300 PALISADE AVENUE	UNION CITY	NJ	07087	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	ATLAS DRUG	8416 KENNEDY BLVD		NORTH BERGEN	NJ	07047	07/18/2013	10/01/2013	05/01/2018	05/01/2018
Contract Detail	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	01/08/2019	04/01/2019	04/15/2019	04/15/2019
Contract Detail	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/15/2019	07/01/2019		07/01/2019
Contract Detail	BERGENLINE DRUGS	4923 BERGENLINE AVE		WEST NEW YORK	NJ	07093-5510	10/25/2012	10/25/2012	07/08/2015	07/28/2015
Contract Detail	BEST PHARMACY & SURGICAL INC	BEST PHARMACY & SURGICAL INC	919 MAIN AVE # STOREB	PASSAIC	NJ	07055-8529	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	BETTER LIFE PHARMACY	301 54TH ST		WEST NEW YORK	NJ	07093	01/18/2022	04/01/2022		04/01/2022
Contract Detail	BOND DRUGS INC.	BOND DRUGS	371 CENTRAL AVE	JERSEY CITY	NJ	07307	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	BUCKLEY'S DRUG STORE	CARLBERT DRUGS, INC.	35 E PALISADE AVE	ENGLEWOOD	NJ	07631-2901	01/25/2013	01/25/2013	07/08/2015	07/28/2015
Contract Detail	CENTRAL PHARMACY	335 60TH ST		WEST NEW YORK	NJ	07093-5412	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	CONTIGO PHARMACY	NJ PHARMALOGICS LLC	3510 BERGENLINE AVE	UNION CITY	NJ	07087-4775	07/12/2019	10/01/2019		10/01/2019
Contract Detail	CONTINENTAL DRUGS	6419-PARK AVE		WEST NEW YORK	NJ	07093	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	CORRECT RX PHARMACY SERVICES	1352 CHARWOOD ROAD	SUITE C	HANOVER	MD	21076	01/15/2019	04/01/2019	10/13/2021	10/14/2021
Contract Detail	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	07/16/2018	10/01/2018		10/01/2018
Contract Detail	DIAMOND PHARMACY SERVICE	DIAMOND PHARMACY SERVICES	645 KOLTER DRIVE	INDIANA	PA	15701	10/14/2016	01/01/2017	05/01/2018	05/01/2018
Contract Detail	DUANE READE	1 PATH PLAZA JOURNAL SQUARE		JERSEY CITY	NJ	07306	07/25/2014	10/01/2014	07/09/2015	07/09/2015
Contract Detail	DUANE READE		1 MAYWOOD AVENUE	MAYWOOD	NJ	07607	07/25/2014	10/01/2014	07/09/2015	07/09/2015
Contract Detail	DUANE READE	1 PATH PLAZA JOURNAL SQUARE		JERSEY CITY	NJ	07306	04/22/2016	07/01/2016	05/01/2018	05/01/2018
Contract Detail	EMED PHARMACY CORP.	HUDSON REGIONAL HOSPITAL	55 MEADOWLANDS PKWY	SECAUCUS	NJ	07094-2977	07/15/2022	10/01/2022	10/02/2023	10/06/2023
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	10/17/2024	01/01/2025		01/01/2025
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	10/17/2024	01/01/2025		01/01/2025
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	10/17/2024	01/01/2025		01/01/2025
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	10/17/2024	01/01/2025		01/01/2025
Contract Detail	FARMACIA SAN JOSE	149 48TH ST		UNION CITY	NJ	07087-6428	04/24/2013	07/01/2013	07/08/2015	07/28/2015
Contract Detail	FARMACIA SANTA MARIA	1115 NEW YORK AVE		UNION CITY	NJ	07087	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	FIRST AID PHARMACY		120 PASSAIC STREET	HACKENSACK	NJ	07601	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	GOODMAN PHARMACY & SURGICAL INC	296 PASSAIC ST		PASSAIC	NJ	07055	07/18/2013	10/01/2013	10/13/2023	02/26/2024
Contract Detail	GOODWILL PHARMACY	GOODWILL PHARMACY	4313 BERGENLINE AVE	UNION CITY	NJ	07087-5067	04/06/2018	07/01/2018		04/06/2018
Contract Detail	HARRYS PHARMACY DEPT.	7917 KENNEDY BLVD		NORTH BERGEN	NJ	07047-4137	07/16/2014	10/01/2014	07/08/2015	07/28/2015
Contract Detail	HEALTH AID DRUGS, INC	212 PALISADE AVE		JERSEY CITY	NJ	07306-1116	01/25/2013	01/25/2013	07/08/2015	07/28/2015
Contract Detail	HEALTH CENTER PHARMACY	6200 BERGENLINE AVE		WEST NEW YORK	NJ	07093	10/25/2012	10/25/2012	01/23/2020	01/27/2020
Contract Detail	HEALTH FAIR PHARMACY	315 WILLOW AVENUE		HOBOKEN	NJ	07030	10/25/2012	10/25/2012	05/09/2016	05/09/2016
Contract Detail	HINES PHARMACY		2301 BERGENLINE AVENUE	UNION CITY	NJ	07087	10/25/2012	10/25/2012	07/08/2015	07/28/2015
Contract Detail	HOBOKEN FAMILY PHARMACY	307 1ST ST		HOBOKEN	NJ	07030-2431	10/25/2012	10/25/2012	07/08/2015	07/28/2015
Contract Detail	HOME TOWNE RX STORE # 2	ZOOBEEDU, INC	635 S. CLINTON AVE SUITE 400	TRENTON	NJ	08611	10/14/2016	01/01/2017	05/01/2018	05/01/2018
Contract Detail	HUDSON SPECIALTY PHARMACY	5313 HUDSON AVE		WEST NEW YORK	NJ	07093	07/15/2020	10/01/2020	10/13/2021	10/14/2021
Contract Detail	J AND J STATE STREET PHARMACY	298 STATE STREET		HACKENSACK	NJ	07601	01/25/2013	01/25/2013	05/16/2016	05/16/2016
Contract Detail	KENNEDY DRUGS LLC	3196A KENNEDY BLVD		UNION CITY	NJ	07087-2436	10/15/2019	01/01/2020	07/15/2022	07/15/2022
Contract Detail	LIBERTY PHARMACY	SVS PHARMACY INC	13 TENAFLY RD	ENGLEWOOD	NJ	07631-2209	07/18/2013	10/01/2013	04/01/2017	04/11/2017
Contract Detail	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	04/15/2018	07/01/2018		04/15/2018
Contract Detail	MEDICINE SHOPPE PHARMACY	487 MARKET ST		SADDLE BROOK	NJ	07663	10/14/2016	01/01/2017	05/01/2018	05/01/2018
Contract Detail	MEDLY PHARMACY	40 W MAIN ST		SOMERVILLE	NJ	08876	07/15/2020	10/01/2020	09/29/2022	10/17/2022
Contract Detail	MEDLY PHARMACY	MEDLY JERSEY CITY INC	152 NEWARK AVE	JERSEY CITY	NJ	07302	07/15/2022	10/01/2022	07/15/2022	10/17/2022
Contract Detail	MIDLAND DRUGS	MIDLAND DRUGS	600 MIDLAND AVE	GARFIELD	NJ	07026-1665	01/25/2013	01/25/2013	04/18/2023	04/21/2023
Contract Detail	NORTH HUDSON COMMUNITY PHARMACY	5301 BROADWAY		WEST NEW YORK	NJ	07093	10/14/2016	01/01/2017		10/14/2016
Contract Detail	NORTH HUDSON PHARMACY AT PASSAIC	220 PASSAIC STREET	SUITE 125-A	PASSAIC	NJ	07055	01/10/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	07/15/2022	10/01/2022		10/01/2022
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	07/15/2022	10/01/2022	06/01/2025	04/15/2025
Contract Detail	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	04/25/2025	07/01/2025		04/25/2025
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	07/15/2022	10/01/2022		10/01/2022
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	07/15/2022	10/01/2022	06/01/2025	04/15/2025
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	07/15/2022	10/01/2022		10/01/2022
Contract Detail	PALISADE DRUG	338 PALISADE AVE		JERSEY CITY	NJ	07307	07/18/2013	10/01/2013	10/14/2015	10/14/2015
Contract Detail	PALISADE DRUG	338 PALISADE AVE		JERSEY CITY	NJ	07307	02/15/2023	02/15/2023		02/15/2023
Contract Detail	PARENTINI'S PHARMACY	2517 BERGENLINE AVENUE		UNION CITY	NJ	07087	04/12/2007	04/12/2007	04/01/2020	04/15/2020
Contract Detail	PARENTINI'S PHARMACY	2517 BERGENLINE AVE		UNION CITY	NJ	07087	04/15/2020	07/01/2020		07/01/2020
Contract Detail	PARENTINI'S PHARMACY	2517 BERGENLINE AVENUE		UNION CITY	NJ	07087	01/10/2023	04/01/2023		04/01/2023
Contract Detail	PARK AVENUE PHARMACY	3712 PARK AVE		WEEHAWKEN	NJ	07086	07/16/2014	10/01/2014	07/08/2015	07/28/2015
Contract Detail	PHARMACY PLUS & SURGICAL SUPPLIES LLC.	236 HARRISON AVE		HARRISON	NJ	07029	04/22/2016	07/01/2016	04/15/2021	04/20/2021
Contract Detail	PHARMACY VALUE	7012 PARK AVE		GUTTENBERG	NJ	07093	07/18/2013	10/01/2013	05/16/2016	05/16/2016
Contract Detail	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	04/15/2018	07/01/2018		04/15/2018
Contract Detail	PRANAV PHARMA INC D/B/A HACKENSACK PHARM		441 PASSAIC STREET	HACKENSACK	NJ	07601	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	PREMIER HEALTH PHARMACY	393 CENTRAL AVE		NEWARK	NJ	07103	10/15/2019	01/01/2020	10/13/2021	10/14/2021
Contract Detail	PRESCRIPTION CTR PHARMACY, INC		C/O RAY CEDENO 1914 BERGENLINE AVENUE	UNION CITY	NJ	07087	10/25/2012	10/25/2012	07/08/2015	07/28/2015
Contract Detail	RELIANT CARE SOLUTIONS	8 NESHAMINY INTERPLEX DR	STE 102	FEASTERVILLE TREVOSE	PA	19053	04/09/2021	07/01/2021		07/01/2021
Contract Detail	RITE AID NEW JERSEY, INC.	RITE AID #7867	47 W PALISADE AVENUE	ENGLEWOOD	NJ	07631	04/18/2016	07/01/2016	08/12/2021	08/19/2021
Contract Detail	RITE AID NEW JERSEY, INC.	RITE AID #1362	123 ANDERSON STREET	HACKENSACK	NJ	07601	04/18/2016	07/01/2016	03/12/2018	03/12/2018
Contract Detail	RITE AID NEW JERSEY, INC.	RITE AID #1731	337 CENTRAL AVENUE	JERSEY CITY	NJ	07307	04/18/2016	07/01/2016	03/12/2018	03/12/2018
Contract Detail	RITE AID OF NEW JERSEY, INC.	RITE AID #542	3100 BERGENLINE AVENUE	UNION CITY	NJ	07087	04/18/2016	07/01/2016	03/12/2018	03/12/2018
Contract Detail	RITE AID OF NEW JERSEY, INC.	RITE AID #2463	219 ESSEX STREET	HACKENSACK	NJ	07601	04/18/2016	07/01/2016	08/12/2021	08/19/2021
Contract Detail	RX E-FILL SOLUTIONS	CARDINAL HEALTH PHARMACY SERVICES, LLC	27680 AVENUE MENTRY STE 100	VALENCIA	CA	91355	07/16/2018	10/01/2018		10/01/2018
Contract Detail	SACHIN PHARMACY INC	295 CENTRAL AVE		JERSEY CITY	NJ	07307	10/25/2012	10/25/2012	07/08/2015	07/28/2015
Contract Detail	SANTA MARINA PHARMACY		3196 KENNEDY BLVD 2ND FLOOR	UNION CITY	NJ	07087	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	SUGARMAN'S DRUG STORE	4207 BERGENLINE AVE		UNION CITY	NJ	07087	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	T&M PHARMACY INC	BROADWAY CONTINENTAL DRUGS	7200 BROADWAY	NORTH BERGEN	NJ	07047	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	THE PEOPLE'S PHARMACY SHOPPE	4012 BERGENLINE AVE		UNION CITY	NJ	07087-4920	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	TONY'S PHARMACY	PASSAIC PHARMACY INC	291 MONROE ST	PASSAIC	NJ	07055	07/18/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	TOWN PHARMACY	SUNRISE WELLNESS INC	4911 BERGENLINE AVE	WEST NEW YORK	NJ	07093-5510	07/16/2014	10/01/2014	07/08/2015	07/28/2015
Contract Detail	UNION CITY PHARMACY	UNION CITY PHARMACY	3214 BERGENLINE AVE	UNION CITY	NJ	07087-0708	07/18/2013	10/01/2013	05/01/2018	05/01/2018
Contract Detail	UNITED PHARMACY WNY LLC	UNITED PHARMACY	6014B BERGENLINE AVE	WEST NEW YORK	NJ	07093-1421	04/24/2013	07/01/2013	07/08/2015	07/28/2015
Contract Detail	VALUE PHARMACY & SURGICAL INC	98A BROADWAY		PASSAIC	NJ	07055-3903	10/25/2012	10/25/2012		03/28/2013
Contract Detail	VB PHARMACY INC.	DBA NORTH BERGEN PHARMACY	7126 BERGENLINE AVE	NORTH BERGEN	NJ	07047-5415	07/16/2013	10/01/2013	07/08/2015	07/28/2015
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/15/2019	01/01/2020		01/01/2020
Contract Detail	WAL-MART PHARMACY 10-3520	400 PARK PLACE		SECAUCUS	NJ	07094	07/13/2016	10/01/2016		07/13/2016
Contract Detail	WAL-MART PHARMACY 10-3795	2100 88TH STREET		NORTH BERGEN	NJ	07047	07/13/2016	10/01/2016		07/13/2016
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/15/2019	01/01/2020		01/01/2020
Contract Detail	WALGREEN EASTERN CO INC	DBA: WALGREENS # 05463	699 BROADWAY	BAYONNE	NJ	07002	07/11/2014	10/01/2014		07/11/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05332	101 PRESIDENT STREET	PASSAIC	NJ	07055	07/11/2014	10/01/2014		07/11/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06253	1561 JOHN F KENNEDY BLVD	JERSEY CITY	NJ	07305-1721	07/11/2014	10/01/2014		07/11/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06382	1138 MAIN AVE	CLIFTON	NJ	07011-2331	07/11/2014	10/01/2014		07/11/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06862	637 HOBOKEN ROAD	CARLSTADT	NJ	07072-1143	07/11/2014	10/01/2014		07/11/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04092	593 MARKET STREET	ELMWOOD PARK	NJ	07407	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05005	639 E 18TH ST	PATERSON	NJ	07501	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05333	3333 PARK AVE	UNION CITY	NJ	07087	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05343	6012 KENNEDY BLVD WEST	WEST NEW YORK	NJ	07093	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06161	100 BROADWAY UNIT 15	ELMWOOD PARK	NJ	07407	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07311	406 S WASHINGTON AVE	BERGENFIELD	NJ	07621-4312	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12406	9255 KENNEDY BLVD.	NORTH BERGEN	NJ	07047	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12442	3508 KENNEDY BLVD.	UNION CITY	NJ	07087	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #13725	101 WASHINGTON ST.	HOBOKEN	NJ	07030-4634	07/25/2014	10/01/2014		07/25/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02968	20 ARNOT ST	LODI	NJ	07644-1614	07/29/2014	10/01/2014		07/29/2014
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03197	2395 KENNEDY BLVD.	JERSEY CITY	NJ	07304	07/29/2014	10/01/2014		07/29/2014
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #18175	123 ANDERSON ST	HACKENSACK	NJ	07601	03/12/2018	03/12/2018		03/12/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19517	337 CENTRAL AVE	JERSEY CITY	NJ	07307	03/12/2018	03/12/2018		03/12/2018
Contract Detail	WALGREEN EASTERN CO., INC.	RITE AID #00542	3100 BERGENLINE AVE	UNION CITY	NJ	07087	03/12/2018	03/12/2018	06/10/2019	01/27/2020
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17797	432 BERGEN ST	HARRISON	NJ	07029	07/18/2022	10/01/2022		10/01/2022
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19995	45 OUTWATER LN STE 3	GARFIELD	NJ	07026-3859	07/18/2022	10/01/2022		10/01/2022
Contract Detail	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	07/25/2014	10/01/2014	07/21/2015	07/21/2015
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	07/25/2014	10/01/2014	07/21/2015	07/21/2015
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	01/17/2023	04/01/2023	01/01/2024	01/01/2024
Contract Detail	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	10/13/2023	01/01/2024		01/01/2024

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH024490	Active	BPS-H80-001173	NORTH HUDSON COMMUNITY ACTION CORPORATION	North Hudson Community Action Corporation @ West New York	5301 BROADWAY	WEST NEW YORK	NJ
CH02449A	Terminated	BPS-H80-004964	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ North Bergen	1116 43rd St	North Bergen	NJ
CH02449B	Active	BPS-H80-001091	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Union City	714 31st St	Union City	NJ
CH02449C	Active	BPS-H80-001090	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Jersey City	324 Palisade Ave	Jersey City	NJ
CH02449E	Terminated	BPS-H80-003038	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Passaic 110	110 MAIN AVE	PASSAIC	NJ
CH02449G	Active	BPS-H80-003004	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Garfield	535 Midland Ave	Garfield	NJ
CH02449H	Active	BPS-H80-007623	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Hackensack	25 E Salem St	Hackensack	NJ
CH02449J	Terminated	BPS-H80-004544	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Hoboken	124 GRAND ST	HOBOKEN	NJ
CH02449K	Active	BPS-H80-021287	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Passaic 220 Passaic Street	220 Passaic Street	Passaic	NJ
CH02449L	Terminated	BPS-H80-004879	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Mobile Health Van	5301 BROADWAY	WEST NEW YORK	NJ
CH02449M	Active	BPS-H80-014317	NORTH HUDSON COMMUNITY ACTION CORPORATION	NHCAC Health Center @ Englewood	197 S Van Brunt St	Englewood	NJ
CH02449N	Terminated	BPS-H80-011452	NORTH HUDSON COMMUNITY ACTION CORPORATION	North Hudson Community Action Corporation @ Dental Mobile Van	5301 Broadway	West New York	NJ
CH02449P	Active	BPS-H80-018268	NORTH HUDSON COMMUNITY ACTION CORPORATION	North Hudson Community Action Corporation Health Center @ Union City High School	2500 Kennedy Blvd	Union City	NJ
CH02449Q	Active	BPS-H80-018269	NORTH HUDSON COMMUNITY ACTION CORPORATION	North Hudson Community Action Coporation-Harrison Health Center	326 Harrison Avenue	Harrison	NJ
CH02449R	Active	BPS-H80-035398	North Hudson Community Action Corporation	North Hudson Community Action Corporation @ Secaucus	55 Meadowlands Pkwy	Secaucus	NJ

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH024490	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	01/01/2025
CH024490	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	01/01/2025
CH024490	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	01/01/2025
CH024490	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	01/01/2025
CH024490	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	01/01/2025
CH024490	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	01/01/2025
CH024490	AHSSHC	EXPEDIEN RX PHARMACY	5050 WESLEY RD STE 120	APOPKA	FL	32712	04/01/2019	10/13/2021
CH024490	AMAZON PHARMACY #001	4500 S PLEASANT VALLEY RD STE 201		AUSTIN	TX	78744-2911	07/01/2018
CH024490	AMERICA'S PHARMACY	1500 SUMMIT AVE.		UNION CITY	NJ	07087-1919	10/01/2014	07/08/2015
CH024490	ANTHONY'S PHARMACY		4300 PALISADE AVENUE	UNION CITY	NJ	07087	10/01/2013	07/08/2015
CH024490	ATLAS DRUG	8416 KENNEDY BLVD		NORTH BERGEN	NJ	07047	10/01/2013	05/01/2018
CH024490	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	04/01/2019	04/15/2019
CH024490	AZ PHARMACY, LLC	DBA AMAZON PHARMACY #002	3809 E WATKINS ST	PHOENIX	AZ	85034	07/01/2019
CH024490	BERGENLINE DRUGS	4923 BERGENLINE AVE		WEST NEW YORK	NJ	07093-5510	10/25/2012	07/08/2015
CH024490	BEST PHARMACY & SURGICAL INC	BEST PHARMACY & SURGICAL INC	919 MAIN AVE # STOREB	PASSAIC	NJ	07055-8529	10/01/2013	07/08/2015
CH024490	BETTER LIFE PHARMACY	301 54TH ST		WEST NEW YORK	NJ	07093	04/01/2022
CH024490	BOND DRUGS INC.	BOND DRUGS	371 CENTRAL AVE	JERSEY CITY	NJ	07307	10/01/2013	07/08/2015
CH024490	BUCKLEY'S DRUG STORE	CARLBERT DRUGS, INC.	35 E PALISADE AVE	ENGLEWOOD	NJ	07631-2901	01/25/2013	07/08/2015
CH024490	CENTRAL PHARMACY	335 60TH ST		WEST NEW YORK	NJ	07093-5412	10/01/2013	07/08/2015
CH024490	CONTIGO PHARMACY	NJ PHARMALOGICS LLC	3510 BERGENLINE AVE	UNION CITY	NJ	07087-4775	10/01/2019
CH024490	CONTINENTAL DRUGS	6419-PARK AVE		WEST NEW YORK	NJ	07093	10/01/2013	07/08/2015
CH024490	CORRECT RX PHARMACY SERVICES	1352 CHARWOOD ROAD	SUITE C	HANOVER	MD	21076	04/01/2019	10/13/2021
CH024490	DELIVERCARERX PHARMACY LLC	DELIVERCARERX PHARMACY LLC	1471 E BUSINESS CENTER DR STE 200	MT PROSPECT	IL	60056	10/01/2018
CH024490	DIAMOND PHARMACY SERVICE	DIAMOND PHARMACY SERVICES	645 KOLTER DRIVE	INDIANA	PA	15701	01/01/2017	05/01/2018
CH024490	DUANE READE	1 PATH PLAZA JOURNAL SQUARE		JERSEY CITY	NJ	07306	10/01/2014	07/09/2015
CH024490	DUANE READE		1 MAYWOOD AVENUE	MAYWOOD	NJ	07607	10/01/2014	07/09/2015
CH024490	DUANE READE	1 PATH PLAZA JOURNAL SQUARE		JERSEY CITY	NJ	07306	07/01/2016	05/01/2018
CH024490	EMED PHARMACY CORP.	HUDSON REGIONAL HOSPITAL	55 MEADOWLANDS PKWY	SECAUCUS	NJ	07094-2977	10/01/2022	10/02/2023
CH024490	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	01/01/2025
CH024490	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	01/01/2025
CH024490	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	01/01/2025
CH024490	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	01/01/2025
CH024490	FARMACIA SAN JOSE	149 48TH ST		UNION CITY	NJ	07087-6428	07/01/2013	07/08/2015
CH024490	FARMACIA SANTA MARIA	1115 NEW YORK AVE		UNION CITY	NJ	07087	10/01/2013	07/08/2015
CH024490	FIRST AID PHARMACY		120 PASSAIC STREET	HACKENSACK	NJ	07601	10/01/2013	07/08/2015
CH024490	GOODMAN PHARMACY & SURGICAL INC	296 PASSAIC ST		PASSAIC	NJ	07055	10/01/2013	10/13/2023
CH024490	GOODWILL PHARMACY	GOODWILL PHARMACY	4313 BERGENLINE AVE	UNION CITY	NJ	07087-5067	07/01/2018
CH024490	HARRYS PHARMACY DEPT.	7917 KENNEDY BLVD		NORTH BERGEN	NJ	07047-4137	10/01/2014	07/08/2015
CH024490	HEALTH AID DRUGS, INC	212 PALISADE AVE		JERSEY CITY	NJ	07306-1116	01/25/2013	07/08/2015
CH024490	HEALTH CENTER PHARMACY	6200 BERGENLINE AVE		WEST NEW YORK	NJ	07093	10/25/2012	01/23/2020
CH024490	HEALTH FAIR PHARMACY	315 WILLOW AVENUE		HOBOKEN	NJ	07030	10/25/2012	05/09/2016
CH024490	HINES PHARMACY		2301 BERGENLINE AVENUE	UNION CITY	NJ	07087	10/25/2012	07/08/2015
CH024490	HOBOKEN FAMILY PHARMACY	307 1ST ST		HOBOKEN	NJ	07030-2431	10/25/2012	07/08/2015
CH024490	HOME TOWNE RX STORE # 2	ZOOBEEDU, INC	635 S. CLINTON AVE SUITE 400	TRENTON	NJ	08611	01/01/2017	05/01/2018
CH024490	HUDSON SPECIALTY PHARMACY	5313 HUDSON AVE		WEST NEW YORK	NJ	07093	10/01/2020	10/13/2021
CH024490	J AND J STATE STREET PHARMACY	298 STATE STREET		HACKENSACK	NJ	07601	01/25/2013	05/16/2016
CH02449C	JERSEY DRUGS INC		286 CENTRAL AVENUE	JERSEY CITY	NJ	07307-3013	02/23/2004	05/16/2016
CH024490	KENNEDY DRUGS LLC	3196A KENNEDY BLVD		UNION CITY	NJ	07087-2436	01/01/2020	07/15/2022
CH024490	LIBERTY PHARMACY	SVS PHARMACY INC	13 TENAFLY RD	ENGLEWOOD	NJ	07631-2209	10/01/2013	04/01/2017
CH024490	M.N. PHARMACY LLC	DBA AMAZON PHARMACY #003	6701 NW 7TH ST., STE. #199	MIAMI	FL	33126	07/01/2018
CH024490	MEDICINE SHOPPE PHARMACY	487 MARKET ST		SADDLE BROOK	NJ	07663	01/01/2017	05/01/2018
CH024490	MEDLY PHARMACY	40 W MAIN ST		SOMERVILLE	NJ	08876	10/01/2020	09/29/2022
CH024490	MEDLY PHARMACY	MEDLY JERSEY CITY INC	152 NEWARK AVE	JERSEY CITY	NJ	07302	10/01/2022	07/15/2022
CH024490	MIDLAND DRUGS	MIDLAND DRUGS	600 MIDLAND AVE	GARFIELD	NJ	07026-1665	01/25/2013	04/18/2023
CH024490	NORTH HUDSON COMMUNITY PHARMACY	5301 BROADWAY		WEST NEW YORK	NJ	07093	01/01/2017
CH02449K	NORTH HUDSON PHARMACY AT PASSAIC	220 PASSAIC STREET	SUITE 125-A	PASSAIC	NJ	07055	04/01/2018
CH024490	NORTH HUDSON PHARMACY AT PASSAIC	220 PASSAIC STREET	SUITE 125-A	PASSAIC	NJ	07055	04/01/2023
CH024490	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	10/01/2022
CH024490	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	10/01/2022	06/01/2025
CH024490	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	07/01/2025
CH024490	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	10/01/2022
CH024490	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	10/01/2022	06/01/2025
CH024490	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	10/01/2022
CH024490	PALISADE DRUG	338 PALISADE AVE		JERSEY CITY	NJ	07307	10/01/2013	10/14/2015
CH024490	PALISADE DRUG	338 PALISADE AVE		JERSEY CITY	NJ	07307	02/15/2023
CH02449B	PARENTINI'S PHARMACY	2517 BERGENLINE AVENUE		UNION CITY	NJ	07087	02/23/2004
CH02449A	PARENTINI'S PHARMACY	2517 BERGENLINE AVENUE		UNION CITY	NJ	07087	04/12/2007	01/01/2022
CH024490	PARENTINI'S PHARMACY	2517 BERGENLINE AVENUE		UNION CITY	NJ	07087	04/12/2007	04/01/2020
CH024490	PARENTINI'S PHARMACY	2517 BERGENLINE AVE		UNION CITY	NJ	07087	07/01/2020
CH024490	PARENTINI'S PHARMACY	2517 BERGENLINE AVENUE		UNION CITY	NJ	07087	04/01/2023
CH024490	PARK AVENUE PHARMACY	3712 PARK AVE		WEEHAWKEN	NJ	07086	10/01/2014	07/08/2015
CH024490	PHARMACY PLUS & SURGICAL SUPPLIES LLC.	236 HARRISON AVE		HARRISON	NJ	07029	07/01/2016	04/15/2021
CH024490	PHARMACY VALUE	7012 PARK AVE		GUTTENBERG	NJ	07093	10/01/2013	05/16/2016
CH024490	PILLPACK LLC	DBA PILLPACK BY AMAZON PHARMACY	250 COMMERCIAL ST STE 2012	MANCHESTER	NH	03101	07/01/2018
CH024490	PRANAV PHARMA INC D/B/A HACKENSACK PHARM		441 PASSAIC STREET	HACKENSACK	NJ	07601	10/01/2013	07/08/2015
CH024490	PREMIER HEALTH PHARMACY	393 CENTRAL AVE		NEWARK	NJ	07103	01/01/2020	10/13/2021
CH024490	PRESCRIPTION CTR PHARMACY, INC		C/O RAY CEDENO 1914 BERGENLINE AVENUE	UNION CITY	NJ	07087	10/25/2012	07/08/2015
CH024490	RELIANT CARE SOLUTIONS	8 NESHAMINY INTERPLEX DR	STE 102	FEASTERVILLE TREVOSE	PA	19053	07/01/2021
CH024490	RITE AID NEW JERSEY, INC.	RITE AID #7867	47 W PALISADE AVENUE	ENGLEWOOD	NJ	07631	07/01/2016	08/12/2021
CH024490	RITE AID NEW JERSEY, INC.	RITE AID #1362	123 ANDERSON STREET	HACKENSACK	NJ	07601	07/01/2016	03/12/2018
CH024490	RITE AID NEW JERSEY, INC.	RITE AID #1731	337 CENTRAL AVENUE	JERSEY CITY	NJ	07307	07/01/2016	03/12/2018
CH024490	RITE AID OF NEW JERSEY, INC.	RITE AID #542	3100 BERGENLINE AVENUE	UNION CITY	NJ	07087	07/01/2016	03/12/2018
CH024490	RITE AID OF NEW JERSEY, INC.	RITE AID #2463	219 ESSEX STREET	HACKENSACK	NJ	07601	07/01/2016	08/12/2021
CH024490	RX E-FILL SOLUTIONS	CARDINAL HEALTH PHARMACY SERVICES, LLC	27680 AVENUE MENTRY STE 100	VALENCIA	CA	91355	10/01/2018
CH024490	SACHIN PHARMACY INC	295 CENTRAL AVE		JERSEY CITY	NJ	07307	10/25/2012	07/08/2015
CH024490	SANTA MARINA PHARMACY		3196 KENNEDY BLVD 2ND FLOOR	UNION CITY	NJ	07087	10/01/2013	07/08/2015
CH024490	SUGARMAN'S DRUG STORE	4207 BERGENLINE AVE		UNION CITY	NJ	07087	10/01/2013	07/08/2015
CH024490	T&M PHARMACY INC	BROADWAY CONTINENTAL DRUGS	7200 BROADWAY	NORTH BERGEN	NJ	07047	10/01/2013	07/08/2015
CH024490	THE PEOPLE'S PHARMACY SHOPPE	4012 BERGENLINE AVE		UNION CITY	NJ	07087-4920	10/01/2013	07/08/2015
CH024490	TONY'S PHARMACY	PASSAIC PHARMACY INC	291 MONROE ST	PASSAIC	NJ	07055	10/01/2013	07/08/2015
CH02449C	TOTAL CARE PHARMACY	267 CENTRAL AVE		JERSEY CITY	NJ	07307-0730	07/01/2020
CH024490	TOWN PHARMACY	SUNRISE WELLNESS INC	4911 BERGENLINE AVE	WEST NEW YORK	NJ	07093-5510	10/01/2014	07/08/2015
CH024490	UNION CITY PHARMACY	UNION CITY PHARMACY	3214 BERGENLINE AVE	UNION CITY	NJ	07087-0708	10/01/2013	05/01/2018
CH024490	UNITED PHARMACY WNY LLC	UNITED PHARMACY	6014B BERGENLINE AVE	WEST NEW YORK	NJ	07093-1421	07/01/2013	07/08/2015
CH024490	VALUE PHARMACY & SURGICAL INC	98A BROADWAY		PASSAIC	NJ	07055-3903	10/25/2012
CH02449G	VARIETY DRUG	50 PASSAIC STREET		GARFIELD	NJ	07026-3159	01/28/2008
CH02449E	VARIETY DRUG	50 PASSAIC STREET		GARFIELD	NJ	07026-3159	01/28/2008	04/01/2018
CH024490	VB PHARMACY INC.	DBA NORTH BERGEN PHARMACY	7126 BERGENLINE AVE	NORTH BERGEN	NJ	07047-5415	10/01/2013	07/08/2015
CH024490	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	01/01/2020
CH024490	WAL-MART PHARMACY 10-3520	400 PARK PLACE		SECAUCUS	NJ	07094	10/01/2016
CH024490	WAL-MART PHARMACY 10-3795	2100 88TH STREET		NORTH BERGEN	NJ	07047	10/01/2016
CH024490	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	01/01/2020
CH024490	WALGREEN EASTERN CO INC	DBA: WALGREENS # 05463	699 BROADWAY	BAYONNE	NJ	07002	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05332	101 PRESIDENT STREET	PASSAIC	NJ	07055	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06253	1561 JOHN F KENNEDY BLVD	JERSEY CITY	NJ	07305-1721	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06382	1138 MAIN AVE	CLIFTON	NJ	07011-2331	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06862	637 HOBOKEN ROAD	CARLSTADT	NJ	07072-1143	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04092	593 MARKET STREET	ELMWOOD PARK	NJ	07407	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05005	639 E 18TH ST	PATERSON	NJ	07501	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05333	3333 PARK AVE	UNION CITY	NJ	07087	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05343	6012 KENNEDY BLVD WEST	WEST NEW YORK	NJ	07093	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06161	100 BROADWAY UNIT 15	ELMWOOD PARK	NJ	07407	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07311	406 S WASHINGTON AVE	BERGENFIELD	NJ	07621-4312	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12406	9255 KENNEDY BLVD.	NORTH BERGEN	NJ	07047	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12442	3508 KENNEDY BLVD.	UNION CITY	NJ	07087	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #13725	101 WASHINGTON ST.	HOBOKEN	NJ	07030-4634	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02968	20 ARNOT ST	LODI	NJ	07644-1614	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03197	2395 KENNEDY BLVD.	JERSEY CITY	NJ	07304	10/01/2014
CH024490	WALGREEN EASTERN CO., INC.	WALGREENS #18175	123 ANDERSON ST	HACKENSACK	NJ	07601	03/12/2018
CH024490	WALGREEN EASTERN CO., INC.	WALGREENS #19517	337 CENTRAL AVE	JERSEY CITY	NJ	07307	03/12/2018
CH024490	WALGREEN EASTERN CO., INC.	RITE AID #00542	3100 BERGENLINE AVE	UNION CITY	NJ	07087	03/12/2018	06/10/2019
CH024490	WALGREEN EASTERN CO., INC.	WALGREENS #17797	432 BERGEN ST	HARRISON	NJ	07029	10/01/2022
CH024490	WALGREEN EASTERN CO., INC.	WALGREENS #19995	45 OUTWATER LN STE 3	GARFIELD	NJ	07026-3859	10/01/2022
CH024490	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	10/01/2014	07/21/2015
CH024490	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	10/01/2014	07/21/2015
CH024490	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023	01/01/2024
CH024490	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH02449H	YORKSHIRE PHARMACY	YORKSHIRE DRUGS LLC	788 MAIN ST	HACKENSACK	NJ	07601-4811	07/01/2018

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/6/2024 11:51:44 AM	2/10/2025 4:48:48 PM	2/10/2025 4:48 PM
Details	Last Recertification Date	Update	Recertification	1/30/2023 3:44:13 PM	2/6/2024 11:51:44 AM	2/6/2024 11:51 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	2/16/2023 4:31 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		0022705	2/16/2023 4:31 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		NJ	2/16/2023 4:31 PM
Details	Last Recertification Date	Update	Recertification	2/7/2022 11:54:14 AM	1/30/2023 3:44:13 PM	1/30/2023 3:44 PM
Details	Last Recertification Date	Update	Recertification	2/23/2021 12:47:21 PM	2/7/2022 11:54:14 AM	2/7/2022 11:54 AM
Contacts	Authorizing Official	Update	Change Request	Quigley, Joan President/CEO NHCAC 2012100100-10100	Acosta, Rebecca Executive Vice President North Hudson Community Action Corporation 2012100100-10102	10/15/2021 10:54 AM
Contacts	Primary Contact	Update	Change Request	Acosta, Rebecca Executive Vice President North Hudson Community Action Corporation 2012100100-10102	Martinez, Amanda Executive Assistant to EVP; 340B Manager FQHC 2014943873	10/15/2021 10:54 AM
Contacts	Primary Contact	Update	Profile Change Request	Acosta, Rebecca Director of Business Development North Hudson Community Action Corporation 2012100100-10102	Acosta, Rebecca Executive Vice President North Hudson Community Action Corporation 2012100100-10102	10/13/2021 11:53 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 2:49:25 PM	2/23/2021 12:47:21 PM	2/23/2021 12:47 PM
Addresses	Shipping Address	Insert	Recertification		North Hudson Community Action Corporation 800 31st Street Union City, NJ 07087	1/28/2020 2:49 PM
Addresses	Shipping Address	Delete	Recertification	NHCAC 403 39TH STREET UNION CITY, NJ 07087		1/28/2020 2:49 PM
Details	Last Recertification Date	Update	Recertification	1/29/2019 10:11:20 AM	1/28/2020 2:49:25 PM	1/28/2020 2:49 PM
Details	Last Recertification Date	Update	Recertification	2/23/2018 11:44:45 AM	1/29/2019 10:11:20 AM	1/29/2019 10:11 AM
Contacts	Primary Contact	Update	Recertification	Quigley, Joan President/CEO NHCAC 2012100100-10100	Acosta, Rebecca Director of Business Development North Hudson Community Action Corporation 2012100100-10102	2/23/2018 11:44 AM
Details	Last Recertification Date	Update	Recertification	1/25/2017 12:00:00 AM	2/23/2018 11:44:45 AM	2/23/2018 11:44 AM
Contacts	Authorizing Official	Update		Quigley, Joan President/CEO 2012100100-10100	Quigley, Joan President/CEO NHCAC 2012100100-10100	11/1/2017 3:59 PM
Contacts	Primary Contact	Update		Quigley, Joan President/CEO 2012100100-10100	Quigley, Joan President/CEO NHCAC 2012100100-10100	11/1/2017 3:59 PM
Contacts	Authorizing Official	Update		Shababb, Michael Interim Pres/CEO 2012100100	Quigley, Joan President/CEO 2012100100-10100	4/27/2017 1:40 PM
Contacts	Primary Contact	Update		Diaz, Manuel Director Business Development 2018669310-11171	Quigley, Joan President/CEO 2012100100-10100	4/27/2017 1:40 PM
Addresses	Main Address	Insert			5301 BROADWAY WEST NEW YORK, NJ 07093-2622	1/25/2017 2:00 PM
Details	Last Recertification Date	Update		3/4/2016 12:00:00 AM	1/25/2017 12:00:00 AM	1/25/2017 2:00 PM
Contacts	Primary Contact	Update		URGOLA, VINCENT A. DIRECTOR OF OPERATIONS 2018669320-230	Diaz, Manuel Director Business Development 2018669310-11171	8/29/2016 2:00 PM
Addresses	Shipping Address	Insert			NHCAC 403 39TH STREET UNION CITY, NJ 07087	4/12/2016 3:45 PM
Details	Last Recertification Date	Update		2/10/2015 12:00:00 AM	3/4/2016 12:00:00 AM	3/4/2016 10:59 AM
Details	Last Recertification Date	Update		2/14/2014 12:00:00 AM	2/10/2015 12:00:00 AM	2/10/2015 12:52 PM
Details	Entity Subname	Update		MAIN SITE	North Hudson Community Action Corporation @ West New York	3/31/2014 4:25 PM
Details	Last Recertification Date	Update		4/1/2013 12:00:00 AM	2/14/2014 12:00:00 AM	2/14/2014 12:03 PM
Contacts	Authorizing Official	Insert			Shababb, Michael Interim Pres/CEO 2012100100	5/10/2013 3:31 PM
Contacts	Primary Contact	Insert			URGOLA, VINCENT A. DIRECTOR OF OPERATIONS 2018669320-230	5/10/2013 3:31 PM
Details	Last Recertification Date	Update			4/1/2013 12:00:00 AM	3/15/2013 6:47 AM
Details	Last Recertification Date	Insert				12/1/2007 8:16 AM
Details	Grant Number	Insert			H80CS00521	12/1/2007 8:16 AM
Details	340B ID	Insert			CH024490	12/1/2007 8:16 AM
Details	Is Authorizing Official EHB Data	Insert				12/1/2007 8:16 AM
Dates	Last Date That 340B Drugs Purchased	Insert				12/1/2007 8:16 AM
Details	Medicare Provider Number	Insert				12/1/2007 8:16 AM
Details	Entity Name	Insert			NORTH HUDSON COMMUNITY ACTION CORPORATION	12/1/2007 8:16 AM
Details	Program Code	Insert			CH	12/1/2007 8:16 AM
Details	Entity Subname	Insert			MAIN SITE	12/1/2007 8:16 AM
Dates	Participating Approval Date	Insert			2/26/2004 12:00:00 AM	12/1/2007 8:16 AM
Details	State	Insert			Active	12/1/2007 8:16 AM
Dates	Registration Date	Insert			1/1/2004 12:00:00 AM	12/1/2007 8:16 AM
Dates	Signed By Date	Insert				12/1/2007 8:16 AM
Dates	Start Date	Insert			1/1/2004 12:00:00 AM	12/1/2007 8:16 AM
Terminations	Termination Comments	Insert				12/1/2007 8:16 AM
Terminations	Termination Date	Insert				12/1/2007 8:16 AM
Terminations	Termination Effective Date	Insert				12/1/2007 8:16 AM
Terminations	Termination Reason	Insert				12/1/2007 8:16 AM

340B Drug Pricing Program Database