Contract Pharmacy Details

PROCARE PHARMACY, L.L.C.
RWI07101 Rutgers, The State University of New Jersey

Covered Entity Details

Entity Name

Rutgers, The State University of New Jersey

Subdivision Name

RBHS-New Jersey Medical School

Type

Ryan White Part A

340B ID

RWI07101

Entity Address

140 Bergen Street
ACC, D- Level, Room D1725
Newark, NJ 07103-0000

Grant Number

H89HA00003

Participating Start Date

1/1/2015

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

PROCARE PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 2919
126 EIGHTH AVE.
NEW YORK, NY 10011

Pharmacy Comments

Contract Details

Approval Date

7/15/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Letitia Dean, Assistant Director, Office of Research and Sponsored Programs
(973) 972-0283

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/15/2019

340B Drug Pricing Program Database