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BARNABAS HEALTH RETAIL PHARMACY DEPT
DSH310084 Monmouth Medical Center Southern Campus
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Covered Entity Details
Entity Name
Monmouth Medical Center Southern Campus
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310084
Entity Address
600 RIVER AVE
LAKEWOOD, NJ 08701
Medicare Provider Number
310084
Participating Start Date
1/1/2015
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
BARNABAS HEALTH RETAIL PHARMACY DEPT
Pharmacy Address
BARNABAS HEALTH RETAIL PHARMACY
300 SECOND AVENUE
LONG BRANCH, NJ 07740
Pharmacy Comments
Contract Details
Approval Date
10/16/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joanna Zimmerman, Chief Financial Officer
(732) 923-7181
Contract Pharmacy Representative
Barnabas Health Retail Pharmacy
Joseph Voelkel, Corporate Director Retail Pharmacy
(973) 322-2946
Signed By Date
10/16/2018
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