340B Drug Pricing Program Database


DSH310074AJ JERSEY CITY MEDICAL CENTER (Active) - information as of 4/28/2025 12:40:28 AM

Main Details
JERSEY CITY MEDICAL CENTER
JERSEY CITY MEDICAL CENTER - Infusion Services at Jersey City Medical Center Specialty Care
Disproportionate Share Hospital
No
DSH310074AJ
310074


Additional Details
Active
4/8/2021
7/1/2021
4/15/2021
8/23/2024

Contacts

Jersey City Medical Center
Alexander Filipiak, Site Finance Officer
(973) 926-8208

RWJBarnabas Health
Bryan McCormick, Corporate Director 340B Program
(973) 322-4022

Addresses

414 GRAND ST
STE 14
JERSEY CITY, NJ 07302-4321

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
NJ41398011689744856
CA 1689744856
CT 1689744856
MD 1689744856
MA 1689744856
NH 1689744856
NY 1689744856
NC 1689744856
PA 1689744856
TN 1689744856
WI 1689744856
AL 1689744856
AZ 1689744856
FL 1689744856
GA 1689744856
IA 1689744856
KY 1689744856
MN 1689744856
MO 1689744856
OH 1689744856
SC 1689744856
TX 1689744856
VA 1689744856
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH310074AChildDSHJERSEY CITY MEDICAL CENTEROUTPATIENT PSYCHIATRY CLINICS395 GRAND STREETJERSEY CITYNJActive
DSH310074AAChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Emergency519 BROADWAYBAYONNENJActive
DSH310074ABChildDSHJERSEY CITY MEDICAL CENTERAmbulatory Surgery Center - Ambulatory Surgery Center377 Jersey AveJersey CityNJActive
DSH310074ACChildDSHJERSEY CITY MEDICAL CENTERGreenville Primary Care - Greenville Primary Care1825 John F. Kennedy BlvdJersey CityNJActive
DSH310074ADChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Pain Management Center414 GRAND STJERSEY CITYNJActive
DSH310074AEChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - GYN Clinic414 GRAND STJERSEY CITYNJActive
DSH310074AFChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Dermatology414 GRAND STJERSEY CITYNJActive
DSH310074AGChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - GYN Oncology414 GRAND STJERSEY CITYNJActive
DSH310074AHChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Orthopedics414 GRAND STJERSEY CITYNJActive
DSH310074AJChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Infusion Services at Jersey City Medical Center Specialty Care414 GRAND STJERSEY CITYNJActive
DSH310074AKChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - RWJBarnabas Health Rutgers NJMS Vascular Center377 JERSEY AVEJERSEY CITYNJActive
DSH310074ALChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Neurosurgery414 GRAND STJERSEY CITYNJActive
DSH310074AMChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Pediatrics414 GRAND STJERSEY CITYNJActive
DSH310074ANChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Urology414 GRAND STJERSEY CITYNJActive
DSH310074APChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Heart Failure414 GRAND STJERSEY CITYNJActive
DSH310074AQChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Infectious Disease414 GRAND STJERSEY CITYNJActive
DSH310074BChildDSHJERSEY CITY MEDICAL CENTERAIDS HEALTH SERVICES1825 JFK BLVDJERSEY CITYNJActive
DSH310074CChildDSHJERSEY CITY MEDICAL CENTERMATERNAL FETAL MEDICINE116 Newark AveJERSEY CITYNJActive
DSH310074DChildDSHJERSEY CITY MEDICAL CENTERLIBERTY WOUND418 SUMMIT AVEJERSEY CITYNJActive
DSH310074EChildDSHJERSEY CITY MEDICAL CENTEROPTHALMOLOGY418 SUMMIT AVEJERSEY CITYNJActive
DSH310074FChildDSHJERSEY CITY MEDICAL CENTERPSY ADULT PART HOSP395 GRAND STREETJERSEY CITYNJActive
DSH310074GChildDSHJERSEY CITY MEDICAL CENTERPSY ADULT OPD395 GRAND STREETJERSEY CITYNJActive
DSH310074HChildDSHJERSEY CITY MEDICAL CENTERCPHU AFTER SCHOOL395 GRAND STREETJERSEY CITYNJActive
DSH310074JChildDSHJERSEY CITY MEDICAL CENTERPSY CHILD OPD395 GRAND STREETJERSEY CITYNJActive
DSH310074KChildDSHJERSEY CITY MEDICAL CENTERPSY ADDICTION PROGRAM395 GRAND STREETJERSEY CITYNJActive
DSH310074LChildDSHJERSEY CITY MEDICAL CENTERPSY ADOL PART HOSP395 GRAND STREETJERSEY CITYNJActive
DSH310074MChildDSHJERSEY CITY MEDICAL CENTERPSY ADULT PH ACUTE395 GRAND STREETJERSEY CITYNJActive
DSH310074NChildDSHJERSEY CITY MEDICAL CENTERINTENSIVE OUTPATIENT SERVICES395 GRAND STREETJERSEY CITYNJActive
DSH310074PChildDSHJERSEY CITY MEDICAL CENTERPSY RESIDENTIAL SVC9 NUNDA AVEJERSEY CITYNJActive
DSH310074QChildDSHJERSEY CITY MEDICAL CENTERPSY SUPPORTIVE HOUSING395 GRAND STJERSEY CITYNJActive
DSH310074RChildDSHJERSEY CITY MEDICAL CENTERPSY INTGD CASE MGMT395 GRAND STREETJERSEY CITYNJActive
DSH310074SChildDSHJERSEY CITY MEDICAL CENTERTHERAPEUTIC NURSERY395 GRAND STREETJERSEY CITYNJActive
DSH310074TChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER / MENTALLY ILL (PATH)1825 JFK BLVDJERSEY CITYNJActive
DSH310074UChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER / CHILDREN CN SPEC NEEDS1825 JFK BLVDJERSEY CITYNJActive
DSH310074VChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER / RYAN WHITE FORMLA AIDS355 GRAND STREETJERSEY CITYNJActive
DSH310074WChildDSHJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER / AIDS HEALTH SERVICES355 GRAND STREETJERSEY CITYNJActive
DSH310074XChildDSHJERSEY CITY MEDICAL CENTEROrthopedic Clinic253 Monmouth StreetJersey CityNJActive
DSH310074YChildDSHJERSEY CITY MEDICAL CENTERCARDIAC DIAGNOSTIC CENTER120 FRANKLIN STREETJERSEY CITYNJActive
DSH310074ZChildDSHJERSEY CITY MEDICAL CENTERDental Clinic - Dental418 Summit AveJersey CityNJActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification AL8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification AZ8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification FL8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification GA8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification IA8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification KY8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification MN8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification MO8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification OH8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification SC8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification TX8/23/2024 9:55 PM
Medicaid BillingNPI: NumberInsertRecertification 16897448568/23/2024 9:55 PM
Medicaid BillingNPI: StateInsertRecertification VA8/23/2024 9:55 PM
DetailsLast Recertification DateUpdateRecertification8/30/2023 9:05:26 AM8/23/2024 9:55:53 PM8/23/2024 9:55 PM
ContactsAuthorizing OfficialUpdateChange RequestZehner, Douglas Senior Vice President Jersey City Medical Center 9739266982Filipiak, Alexander Site Finance Officer Jersey City Medical Center 97392682087/30/2024 10:54 AM
ContactsAuthorizing OfficialUpdateChange RequestFilipiak, Alexander Site Finance Officer Jersey City Medical Center 7327890072Zehner, Douglas Senior Vice President Jersey City Medical Center 97392669825/31/2024 7:14 AM
ContactsAuthorizing OfficialUpdateChange RequestHollis, Carla COO Jersey City Medical Center 2019152944Filipiak, Alexander Site Finance Officer Jersey City Medical Center 73278900723/20/2024 7:30 AM
DetailsLast Recertification DateUpdateRecertification8/30/2022 8:50:18 AM8/30/2023 9:05:26 AM8/30/2023 9:05 AM
DetailsLast Recertification DateUpdateRecertification8/27/2021 9:47:25 AM8/30/2022 8:50:18 AM8/30/2022 8:50 AM
ContactsAuthorizing OfficialUpdateChange RequestValentine, Robert CFO Jersey City Medical Center 2015215920Hollis, Carla COO Jersey City Medical Center 20191529444/26/2022 12:43 PM
DetailsLast Recertification DateUpdateRecertification 8/27/2021 9:47:25 AM8/27/2021 9:47 AM
DetailsStateUpdate ApprovedActive7/1/2021 12:01 AM
ContactsSigned ByInsertNew Registration Valentine, Robert CFO Jersey City Medical Center 20152159204/15/2021 2:40 PM
Details340B IDUpdateNew Registration DSH310074AJ4/15/2021 2:40 PM
DetailsEntity SubnameUpdateNew RegistrationJERSEY CITY MEDICAL CENTERJERSEY CITY MEDICAL CENTER - Infusion Services at Jersey City Medical Center Specialty Care4/15/2021 2:40 PM
DatesParticipating Approval DateUpdateNew Registration 4/15/2021 2:40:41 PM4/15/2021 2:40 PM
DetailsStateUpdateNew RegistrationPendingApproved4/15/2021 2:40 PM
DatesSigned By DateUpdateNew Registration 4/12/2021 8:35:50 AM4/15/2021 2:40 PM
DatesStart DateUpdateNew Registration 7/1/2021 12:00:00 AM4/15/2021 2:40 PM
AddressesMain AddressInsertNew Registration  414 GRAND ST STE 14 JERSEY CITY, NJ 07302-43214/8/2021 11:06 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False4/8/2021 11:06 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 41398014/8/2021 11:06 AM
Medicaid BillingMedicaid: StateInsertNew Registration NJ4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration NJ4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration CA4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration CT4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration MD4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration MA4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration NH4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration NY4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration NC4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration PA4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration TN4/8/2021 11:06 AM
Medicaid BillingNPI: NumberInsertNew Registration 16897448564/8/2021 11:06 AM
Medicaid BillingNPI: StateInsertNew Registration WI4/8/2021 11:06 AM
ContactsAuthorizing OfficialInsertNew Registration Valentine, Robert CFO Jersey City Medical Center 20152159204/8/2021 11:06 AM
ContactsPrimary ContactInsertNew Registration McCormick, Bryan Corporate Director 340B Program RWJBarnabas Health 97332240224/8/2021 11:06 AM
DetailsAssistance Received From DateInsertNew Registration  4/8/2021 11:06 AM
DetailsAssistance Received To DateInsertNew Registration  4/8/2021 11:06 AM
DetailsLast Recertification DateInsertNew Registration  4/8/2021 11:06 AM
DetailsGrant NumberInsertNew Registration  4/8/2021 11:06 AM
Details340B IDInsertNew Registration  4/8/2021 11:06 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  4/8/2021 11:06 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  4/8/2021 11:06 AM
DetailsMedicare Provider NumberInsertNew Registration 3100744/8/2021 11:06 AM
DetailsEntity NameInsertNew Registration JERSEY CITY MEDICAL CENTER4/8/2021 11:06 AM
DetailsNOFO NumberInsertNew Registration  4/8/2021 11:06 AM
DetailsProgram CodeInsertNew Registration DSH4/8/2021 11:06 AM
DetailsEntity SubnameInsertNew Registration JERSEY CITY MEDICAL CENTER4/8/2021 11:06 AM
DatesParticipating Approval DateInsertNew Registration  4/8/2021 11:06 AM
DetailsStateInsertNew Registration Pending4/8/2021 11:06 AM
DatesRegistration DateInsertNew Registration 4/8/2021 11:06:03 AM4/8/2021 11:06 AM
DatesSigned By DateInsertNew Registration  4/8/2021 11:06 AM
DatesStart DateInsertNew Registration  4/8/2021 11:06 AM
TerminationsTermination CommentsInsertNew Registration  4/8/2021 11:06 AM
TerminationsTermination DateInsertNew Registration  4/8/2021 11:06 AM
TerminationsTermination Effective DateInsertNew Registration  4/8/2021 11:06 AM
TerminationsTermination ReasonInsertNew Registration  4/8/2021 11:06 AM