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COORDINATED CARE NETWORK PHARMACY
STD18901 Novus Adult Care Services
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Covered Entity Details
Entity Name
Novus Adult Care Services
Subdivision Name
Doylestown Office
Type
Sexually Transmitted Diseases
340B ID
STD18901
Entity Address
11 Duane Road
Suite A
Doylestown, PA 18901
Grant Number
NH25PS005144
Participating Start Date
10/1/2019
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
268 MARTIN LUTHER KING JR. BLVD.
NEWARK, NJ 07102
Pharmacy Comments
Contract Details
Approval Date
8/5/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen C Smith, owner
(610) 867-5365
Contract Pharmacy Representative
CCN AMERICA LP
Thomas J. Pollack, Vice President and CFO
(412) 349-6303
Signed By Date
7/10/2019
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