Contract Pharmacy Details

SMITH PHARMACY
CH027000 Central Jersey Medical Center Inc.

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

SMITH PHARMACY

Pharmacy Address

91 SMITH ST
PERTH AMBOY, NJ 08861-4413

Pharmacy Comments

Contract Details

Approval Date

7/9/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul McCloud, CFO
(732) 376-6602

Contract Pharmacy Representative

Aarti Shah, Owner
(732) 661-6625

Signed By Date

7/9/2015

340B Drug Pricing Program Database