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DUANE READE PHCY. DEPT.
CH020710 NEWARK DEPARTMENT OF HEALTH AND HUMAN SERVICES
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Covered Entity Details
Entity Name
NEWARK DEPARTMENT OF HEALTH AND HUMAN SERVICES
Subdivision Name
Mary Eliza Mahoney Health Center @110 William Street
Type
HRSA-Funded Health Center
340B ID
CH020710
Entity Address
110 WILLIAM STREET
ROOM 208
NEWARK, NJ 07102
Grant Number
H80CS00009
Participating Start Date
4/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
DUANE READE PHCY. DEPT.
Pharmacy Address
110 NEWARK AVENUE
JERSEY CITY, NJ 07302
Pharmacy Comments
11/02/2012 DEA check, name update (was Walgreens 14402)
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark J Wade, CEO
(973) 733-5310
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2018
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