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PREMIER HEALTH PHARMACY
CH024490 NORTH HUDSON COMMUNITY ACTION CORPORATION
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Covered Entity Details
Entity Name
NORTH HUDSON COMMUNITY ACTION CORPORATION
Subdivision Name
North Hudson Community Action Corporation @ West New York
Type
HRSA-Funded Health Center
340B ID
CH024490
Entity Address
5301 BROADWAY
WEST NEW YORK, NJ 07093-2622
Grant Number
H80CS00521
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
PREMIER HEALTH PHARMACY
Pharmacy Address
393 CENTRAL AVE
NEWARK, NJ 07103
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/13/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joan Quigley, President/CEO
(201) 210-0100 Ext: 10100
Contract Pharmacy Representative
Barry's Montville Pharmacy
Amit Patel, Owner
(908) 420-5524
Signed By Date
10/15/2019
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