340B Drug Pricing Program Database
COORDINATED CARE NETWORK PHARMACY
FP07103 Rutgers, The State University of New Jersey - information as of 6/16/2025 11:38:46 PM
Covered Entity Details
Entity Name
Rutgers, The State University of New Jersey
Subdivision Name
RBHS-NJMS Department of Pediatrics Division of Adolescent and Young Adult Medicine
Type
Family Planning (Title X only)
340B ID
FP07103
Entity Address
90 Bergen Street
Suite 4400
Newark, NJ 07103
Grant Number
FPHPA006527-04
Participating Start Date
1/1/2019
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
268 MARTIN LUTHER KING JR. BLVD.
NEWARK, NJ 07102
Pharmacy Comments
Contract Details
Approval Date
12/18/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diane M Ambrose, Director, Office of Research and Sponsored Programs
(848) 932-4037
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
12/18/2018
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