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CH02071C CITY OF NEWARK, NEW JERSEY (Active)
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Main Details
Name
CITY OF NEWARK, NEW JERSEY
Subdivision Name
Mary Eliza Mahoney Health Center Mobile Medical Unit
Type
HRSA-Funded Health Center
Site ID
BPS-H80-006415
340B ID
CH02071C
Grant Number
H80CS00009
Additional Details
Current Program Status
Active
Registration Date
1/12/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/1/2018
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
City of Newark
Ketlen Alsbrook, Director & CEO
(973) 733-5310
Primary Contact
Newark Department of Health and Community Wellness/Mary Eliza Mahoney Health Center
Alexandria Massey, Chief Operating Officer
(973) 877-6187
Addresses
Street Address
394 UNIVERSITY AVE
NEWARK, NJ 07102-1221
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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