Contract Pharmacy Details

CVS PHARMACY, INC.
STD071033 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

Sexually Transmitted Diseases

340B ID

STD071033

Entity Address

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

Grant Number

NH25PS005174-08

Participating Start Date

10/1/2019

Last Recertification Date

5/5/2025

Pharmacy Details

Pharmacy Name

CVS PHARMACY, INC.

Pharmacy Address

DBA: CVS/PHARMACY # 00746
171 NORTH MAIN STREET
RANDOLPH, MA 02368

Pharmacy Comments

Contract Details

Approval Date

1/14/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

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

1/14/2020

340B Drug Pricing Program Database