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J AND J STATE STREET 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
J AND J STATE STREET PHARMACY
Pharmacy Address
298 STATE STREET
HACKENSACK, NJ 07601
Pharmacy Comments
Contract Details
Approval Date
1/25/2013
Contract Begin Date
1/25/2013
Carve-In Effective Date
Contract Comments
01/25/2013 - public health emergency declared in the state of NJ effective 10/26/2012
Contract Termination Date
Termination Reason
5/16/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christopher Irizarry, President/CEO
(201) 210-0100
Contract Pharmacy Representative
J and J State Street Pharmacy
James DeMicco, Pharmacist
(201) 820-3360
Signed By Date
1/7/2013
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