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WAL-MART PHARMACY 10-3795
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
WAL-MART PHARMACY 10-3795
Pharmacy Address
2100 88TH STREET
NORTH BERGEN, NJ 07047
Pharmacy Comments
Contract Details
Approval Date
7/13/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joan Quigley, President/CEO
(201) 210-0100 Ext: 10100
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
7/13/2016
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