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SOUTH BROAD PHARMACY
CH020500 NEWARK COMMUNITY HEALTH CENTERS INC
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Covered Entity Details
Entity Name
NEWARK COMMUNITY HEALTH CENTERS INC
Subdivision Name
NEWARK COMMUNITY HEALTH CENTERS, INC.
Type
HRSA-Funded Health Center
340B ID
CH020500
Entity Address
741 BROADWAY
NEWARK, NJ 07104-4309
Grant Number
H80CS00062
Participating Start Date
1/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
SOUTH BROAD PHARMACY
Pharmacy Address
SOUTH BROAD PHARMACY
530 WESTFIELD AVE.
ELIZABETH, NJ 07208
Pharmacy Comments
Contract Details
Approval Date
7/13/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PAMELA CLARKE, PRESIDENT/CEO
(973) 483-1300 Ext: 1302
Contract Pharmacy Representative
Umesh Patel, Owner
(908) 469-4061
Signed By Date
7/13/2015
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