340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BERGEN PHARMACY
STD07108 Hyacinth AIDS Foundation
Print
Covered Entity Details
Entity Name
Hyacinth AIDS Foundation
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD07108
Entity Address
201 Washington Street
Newark, NJ 07102
Grant Number
NH25PS005174-05-06
Participating Start Date
1/1/2019
Last Recertification Date
5/16/2024
Pharmacy Details
Pharmacy Name
BERGEN PHARMACY
Pharmacy Address
BERGEN PHARMACY
194 CLINTON AVE
NEWARK, NJ 07108-2809
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathy Ahearn-O'Brien, Executive Director
(732) 246-0204
Contract Pharmacy Representative
Bergen Pharmacy
Jaydeep Manek, Pharmacist
(973) 273-1100
Signed By Date
4/15/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session