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WESTSIDE PHARMACY
CH020070 HENRY J. AUSTIN HEALTH CENTER INC
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Covered Entity Details
Entity Name
HENRY J. AUSTIN HEALTH CENTER INC
Subdivision Name
Henry J. Austin Health Center - Warren
Type
HRSA-Funded Health Center
340B ID
CH020070
Entity Address
321 N Warren St.
Trenton, NJ 08618-4741
Grant Number
H80CS00531
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WESTSIDE PHARMACY
Pharmacy Address
SOHUM RX LLC
215 N HERMITAGE AVE # 9
TRENTON, NJ 08618-5531
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kemi Alli, Chief Executive Officer
(609) 278-5909
Contract Pharmacy Representative
West Side Pharmacy
Pete Sutaria, Pharmacy Owner
(609) 394-0600
Signed By Date
7/16/2018
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