340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
NEW JERSEY CVS PHARMACY, L.L.C.
DSH310086 KENNEDY MEMORIAL HOSPITAL-UMC
Print
Covered Entity Details
Entity Name
KENNEDY MEMORIAL HOSPITAL-UMC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310086
Entity Address
18 East Laurel Road
Stratford, NJ 08084
Medicare Provider Number
310086
Participating Start Date
4/1/2016
Last Recertification Date
9/4/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
NEW JERSEY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00836
824 BLACK HORSE PIKE
RUNNEMEDE, NJ 08078
Pharmacy Comments
Contract Details
Approval Date
1/19/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
John W Graham, VP - Chief Administrative Officer
(856) 582-2661
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/19/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session