Contract Pharmacy Details

RENAISSANCE 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

RENAISSANCE PHARMACY

Pharmacy Address

RETAIL PHARMACY
275 HOBART ST
PERTH AMBOY, NJ 08861-3396

Pharmacy Comments

Contract Details

Approval Date

3/16/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2023
Ownership change

Contacts

Covered Entity Signing Official

Paul McCloud, CFO
(732) 376-6602

Contract Pharmacy Representative

Health Care Pharmacy
Hemil Khandwala, President
(973) 865-6577

Signed By Date

3/16/2016

340B Drug Pricing Program Database