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CEDENO'S PHARMACY
CH027000 Central Jersey Medical Center Inc.
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Covered Entity Details
Entity Name
Central Jersey Medical Center Inc.
Subdivision Name
Central Jersey Medical Center Inc.
Type
HRSA-Funded Health Center
340B ID
CH027000
Entity Address
275 Hobart St
Perth Amboy, NJ 08861-4310
Grant Number
H80CS00253
Participating Start Date
1/1/2005
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
CEDENO'S PHARMACY
Pharmacy Address
NEIGHBOR CARE PHARMACY INC.
400 STATE STREET
PERTH AMBOY, NJ 08861-3437
Pharmacy Comments
Contract Details
Approval Date
1/7/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Daniel Vaysberg, Operation Analyst
(732) 376-6672
Contract Pharmacy Representative
Cedeno Pharmacy
Snehal Shah, Pharmacy Representative
(732) 442-4478
Signed By Date
1/7/2019
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