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WALGREEN EASTERN CO., INC
CH020930 SOUTHERN JERSEY FAMILY MEDICAL CENTERS, INC.
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Covered Entity Details
Entity Name
SOUTHERN JERSEY FAMILY MEDICAL CENTERS, INC.
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH020930
Entity Address
860 S WHITE HORSE PIKE
HAMMONTON, NJ 08037-2018
Grant Number
H80CS00380
Participating Start Date
9/9/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC
Pharmacy Address
WALGREENS #19667
1315 NEW RD
NORTHFIELD, NJ 08225
Pharmacy Comments
Contract Details
Approval Date
7/8/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LINDA Y. FLAKE, CEO
(609) 567-0434 Ext: 4116
Contract Pharmacy Representative
Southern Jersey Family Medical Centers, Inc.
Ronald Kaplan, CFO
(609) 567-0434 Ext: 4142
Signed By Date
7/8/2019
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