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RITE AID NEW JERSEY, INC.
CHC12855-00 MONMOUTH FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
MONMOUTH FAMILY HEALTH CENTER
Subdivision Name
Monmouth Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12855-00
Entity Address
270 Broadway
Long Branch, NJ 07740-0727
Grant Number
H80CS12855
Participating Start Date
10/14/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID NEW JERSEY, INC.
Pharmacy Address
RITE AID #802
205 MORRIS AVENUE
LONG BRANCH, NJ 07740
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/4/2018
Ownership change
Contacts
Covered Entity Signing Official
Marta C Silverberg, CEO
(732) 923-7145
Contract Pharmacy Representative
walgreens
Jeffrey Wierczorek, representativw
(847) 964-7503
Signed By Date
7/17/2018
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