Yes
NJ | 3675807 | 1609983790 |
CT | | 1609983790 |
MD | | 1609983790 |
NY | | 1609983790 |
NC | | 1609983790 |
PA | | 1609983790 |
TN | | 1609983790 |
VT | | 1609983790 |
VA | | 1609983790 |
WA | | 1609983790 |
WI | | 1609983790 |
AL | | 1609983790 |
CA | | 1609983790 |
CO | | 1609983790 |
FL | | 1609983790 |
MA | | 1609983790 |
MN | | 1609983790 |
MO | | 1609983790 |
TX | | 1609983790 |
UT | | 1609983790 |
DSH310075A | Child | DSH | MONMOUTH MEDICAL CENTER | Vantage Point Infusion Center | 100 State Highway 36 | west long branch | NJ | Active |
DSH310075B | Child | DSH | MONMOUTH MEDICAL CENTER | PSYCH CLINIC | 3301 HIGHWAY 66 BLDG B SUITE 201 EARLY INTERVENTION SUPPORT SERVICE | NEPTUNE | NJ | Active |
DSH310075C | Child | DSH | MONMOUTH MEDICAL CENTER | Pollak Clinic | 75 North Bath Avenue | Long Branch | NJ | Active |
DSH310075D | Child | DSH | MONMOUTH MEDICAL CENTER | LAB AND XRAY | 1910 HIGHWAY 35 | OAKHURST | NJ | Active |
DSH310075E | Child | DSH | MONMOUTH MEDICAL CENTER | Jacqueline M. Wilentz Breast Center at Colts Neck | 310 Route 34, Second Floor | Colts Neck | NJ | Active |
DSH310075F | Child | DSH | MONMOUTH MEDICAL CENTER | Jacqueline M. Wilentz Breast Center at Howell | 4013 Route 9 | Howell | NJ | Active |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | AL | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | CA | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | CO | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | FL | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | MA | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | MN | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | MO | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | TX | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 8/22/2024 12:01 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | UT | 8/22/2024 12:01 PM |
Details | Last Recertification Date | Update | Recertification | 8/29/2023 9:54:28 AM | 8/22/2024 12:01:50 PM | 8/22/2024 12:01 PM |
Details | Last Recertification Date | Update | Recertification | 9/6/2022 9:48:38 AM | 8/29/2023 9:54:28 AM | 8/29/2023 9:54 AM |
Details | Last Recertification Date | Update | Recertification | 9/9/2021 11:45:44 AM | 9/6/2022 9:48:38 AM | 9/6/2022 9:48 AM |
Contacts | Authorizing Official | Update | Change Request | Alexiades, Nikolas
CFO
RWJBarnabas Health
9739267824 | Lasker, Cory
V.P. Financial Services
Monmouth Medical Center
7329236289 | 10/22/2021 11:56 AM |
Details | Last Recertification Date | Update | Recertification | 9/11/2020 3:33:21 PM | 9/9/2021 11:45:44 AM | 9/9/2021 11:45 AM |
Contacts | Primary Contact | Update | Profile Change Request | McCormick, Bryan
340B Program Manager
RWJBarnabas Health
9733224022 | McCormick, Bryan
Corporate Director 340B Program
RWJBarnabas Health
9733224022 | 2/3/2021 5:53 PM |
Medicaid Billing | NPI: State | Update | Recertification | | CT | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | NJ | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | MD | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | NY | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | NC | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | PA | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | TN | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | VT | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | VA | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | WA | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1609983790 | 9/11/2020 3:33 PM |
Medicaid Billing | NPI: State | Insert | Recertification | | WI | 9/11/2020 3:33 PM |
Details | Last Recertification Date | Update | Recertification | 9/5/2019 12:10:23 PM | 9/11/2020 3:33:21 PM | 9/11/2020 3:33 PM |
Contacts | Primary Contact | Update | Change Request | Pellechio, Robert
VICE PRESIDENT, Corp Pharmacy
RWJBarnabas
9733224327 | McCormick, Bryan
340B Program Manager
RWJBarnabas Health
9733224022 | 5/21/2020 1:02 PM |
Details | Last Recertification Date | Update | Recertification | 9/7/2018 3:39:18 PM | 9/5/2019 12:10:23 PM | 9/5/2019 12:10 PM |
Contacts | Authorizing Official | Update | Change Request | Zimmerman, Joanna
Chief Financial Officer
Monmouth Medical Center
7329237181 | Alexiades, Nikolas
CFO
RWJBarnabas Health
9739267824 | 6/12/2019 10:42 AM |
Details | Last Recertification Date | Update | Recertification | 11/14/2017 4:35:25 PM | 9/7/2018 3:39:18 PM | 9/7/2018 3:39 PM |
Details | Last Recertification Date | Update | Recertification | 8/30/2016 12:00:00 AM | 11/14/2017 4:35:25 PM | 11/14/2017 4:35 PM |
Contacts | Authorizing Official | Update | | Zimmerman, Joanna
Chief Financial Officer
7329237181 | Zimmerman, Joanna
Chief Financial Officer
Monmouth Medical Center
7329237181 | 11/14/2017 4:30 PM |
Contacts | Primary Contact | Update | | Pellechio, Robert
VICE PRESIDENT, Corp Pharmacy
9733224327 | Pellechio, Robert
VICE PRESIDENT, Corp Pharmacy
RWJBarnabas
9733224327 | 9/19/2017 10:37 AM |
Contacts | Primary Contact | Insert | | | Pellechio, Robert
VICE PRESIDENT, Corp Pharmacy
9733224327 | 8/8/2017 9:19 AM |
Contacts | Authorizing Official | Insert | | | Zimmerman, Joanna
Chief Financial Officer
7329237181 | 4/5/2017 11:36 AM |
Contacts | Signed By | Insert | | | McClung, David
CFO
7329237181 | 1/12/2017 10:10 AM |
Addresses | Main Address | Insert | | |
1910 HIGHWAY 35
OAKHURST, NJ 07755-2715 | 8/30/2016 2:54 PM |
Details | Last Recertification Date | Update | | | 8/30/2016 12:00:00 AM | 8/30/2016 2:54 PM |
Dates | Participating Approval Date | Update | | | 7/17/2015 12:00:00 AM | 7/17/2015 10:09 AM |
Details | State | Update | | Pending | Active | 7/17/2015 10:09 AM |
Dates | Start Date | Update | | | 10/1/2015 12:00:00 AM | 7/17/2015 10:09 AM |
Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG_52727 | DSH310075D | 7/16/2015 12:35 PM |
Details | Entity Subname | Update | | MONMOUTH MEDICAL CENTER | LAB AND XRAY | 7/16/2015 12:35 PM |
Details | 340B ID | Update | | | OUTPATIENT_ONLINE_REG_52727 | 7/9/2015 9:29 AM |
Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 7/9/2015 9:29 AM |
Medicaid Billing | Medicaid: Number | Insert | | | 3675807 | 7/9/2015 9:29 AM |
Medicaid Billing | Medicaid: State | Insert | | | NJ | 7/9/2015 9:29 AM |
Medicaid Billing | NPI: Number | Insert | | | 1609983790 | 7/9/2015 9:29 AM |
Details | Last Recertification Date | Insert | | | | 7/9/2015 9:29 AM |
Details | Grant Number | Insert | | | | 7/9/2015 9:29 AM |
Details | 340B ID | Insert | | | | 7/9/2015 9:29 AM |
Details | Is Authorizing Official EHB Data | Insert | | | | 7/9/2015 9:29 AM |
Dates | Last Date That 340B Drugs Purchased | Insert | | | | 7/9/2015 9:29 AM |
Details | Medicare Provider Number | Insert | | | 310075 | 7/9/2015 9:29 AM |
Details | Entity Name | Insert | | | MONMOUTH MEDICAL CENTER | 7/9/2015 9:29 AM |
Details | Program Code | Insert | | | DSH | 7/9/2015 9:29 AM |
Details | Entity Subname | Insert | | | MONMOUTH MEDICAL CENTER | 7/9/2015 9:29 AM |
Dates | Participating Approval Date | Insert | | | | 7/9/2015 9:29 AM |
Details | State | Insert | | | Pending | 7/9/2015 9:29 AM |
Dates | Registration Date | Insert | | | 7/9/2015 12:00:00 AM | 7/9/2015 9:29 AM |
Dates | Signed By Date | Insert | | | 7/9/2015 12:00:00 AM | 7/9/2015 9:29 AM |
Dates | Start Date | Insert | | | | 7/9/2015 9:29 AM |
Terminations | Termination Comments | Insert | | | | 7/9/2015 9:29 AM |
Terminations | Termination Date | Insert | | | | 7/9/2015 9:29 AM |
Terminations | Termination Effective Date | Insert | | | | 7/9/2015 9:29 AM |
Terminations | Termination Reason | Insert | | | | 7/9/2015 9:29 AM |