Contract Pharmacy Details

DEVINE PHARMACY LLC
CH021230 NEIGHBORHOOD HEALTH SERVICES CORPORATION

Covered Entity Details

Entity Name

NEIGHBORHOOD HEALTH SERVICES CORPORATION

Subdivision Name

Neighborhood Health Center Plainfield

Type

HRSA-Funded Health Center

340B ID

CH021230

Entity Address

1700-58 MYRTLE AVENUE
PLAINFIELD, NJ 07063-1038

Grant Number

H80CS00645

Participating Start Date

4/1/1997

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

DEVINE PHARMACY LLC

Pharmacy Address

D/B/A DEVINES PHARMACY
2 S. WASHINGTON AVE
DUNELLEN, NJ 08812

Pharmacy Comments

Contract Details

Approval Date

4/17/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/7/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Sobande F Afolabi, VP/ Chief of Legal Affairs
(908) 922-4113

Contract Pharmacy Representative

Devine Pharmacy
Raj Kumar, Owner
(732) 968-0003

Signed By Date

4/17/2019

340B Drug Pricing Program Database