Contract Pharmacy Details

NEW JERSEY CVS PHARMACY, L.L.C.
RWI07101 Rutgers, The State University of New Jersey

Covered Entity Details

Entity Name

Rutgers, The State University of New Jersey

Subdivision Name

RBHS-New Jersey Medical School

Type

Ryan White Part A

340B ID

RWI07101

Entity Address

140 Bergen Street
ACC, D- Level, Room D1725
Newark, NJ 07103-0000

Grant Number

H89HA00003

Participating Start Date

1/1/2015

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

NEW JERSEY CVS PHARMACY, L.L.C.

Pharmacy Address

DBA CVS/PHARMACY #10322
302 ROUTE 94
VERNON, NJ 07462

Pharmacy Comments

Contract Details

Approval Date

4/14/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Letitia Dean, Assistant Director, Office of Research and Sponsored Programs
(973) 972-0283

Contract Pharmacy Representative

CVS Health
Christian Reid, 340B Program Director
(401) 770-2118

Signed By Date

4/14/2021

340B Drug Pricing Program Database