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UNITED DRUGS
CH027000 Central Jersey Medical Center Inc.
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Covered Entity Details
Entity Name
Central Jersey Medical Center Inc.
Subdivision Name
Central Jersey Medical Center Inc.
Type
HRSA-Funded Health Center
340B ID
CH027000
Entity Address
275 Hobart St
Perth Amboy, NJ 08861-4310
Grant Number
H80CS00253
Participating Start Date
1/1/2005
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
UNITED DRUGS
Pharmacy Address
507 CENTRAL AVE
NEWARK, NJ 07107-1466
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
1/1/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul McCloud, CFO
(732) 376-6602
Contract Pharmacy Representative
Siva Tallavajhala, Manager
(973) 482-9300
Signed By Date
1/11/2013
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