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MIGUEL'S PHARMACY
CH021280 CAMCARE HEALTH CORPORATION
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Covered Entity Details
Entity Name
CAMCARE HEALTH CORPORATION
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH021280
Entity Address
817 FEDERAL STREET
CAMDEN, NJ 08103
Grant Number
H80CS00172
Participating Start Date
1/1/2002
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
MIGUEL'S PHARMACY
Pharmacy Address
1787 RIVER RD
CAMDEN, NJ 08105
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Roberts, President / CEO
(856) 541-3270
Contract Pharmacy Representative
Miguel's Pharmacy
Viswa Prakash Mantena, Owner
(908) 745-9499
Signed By Date
4/15/2020
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