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RITE AID NEW JERSEY, INC.
CHC12855-02 MONMOUTH FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
MONMOUTH FAMILY HEALTH CENTER
Subdivision Name
Monmouth Family Health Center OB/GYN Womens Health Services
Type
HRSA-Funded Health Center
340B ID
CHC12855-02
Entity Address
80 Pavilion Ave
Long Branch, NJ 07740-6413
Grant Number
H80CS12855
Participating Start Date
7/1/2012
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID NEW JERSEY, INC.
Pharmacy Address
RITE AID #4799
2000 STATE HIGHWAY 35 S
OAKHURST, NJ 07755
Pharmacy Comments
Contract Details
Approval Date
4/13/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2019
Ownership change
Contacts
Covered Entity Signing Official
Marta C Silverberg, CEO
(732) 923-7145
Contract Pharmacy Representative
walgreens
Raquel Brown, Contact
(847) 315-1272
Signed By Date
4/13/2019
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