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COORDINATED CARE NETWORK PHARMACY
RWI07103 North Jersey AIDS Alliance dba North Jersey Community Research Initiative (NJCRI)
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Covered Entity Details
Entity Name
North Jersey AIDS Alliance dba North Jersey Community Research Initiative (NJCRI)
Subdivision Name
Type
Ryan White Part A
340B ID
RWI07103
Entity Address
393 Central Avenue
Newark, NJ 07103
Grant Number
H89HA00003
Participating Start Date
7/1/2013
Last Recertification Date
2/11/2025
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
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brian McGovern, CEO
(973) 849-0084
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
1/15/2020
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