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MCDERMOTT PHARMACY
RWI07509 Paterson Counseling Center, Inc.
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Covered Entity Details
Entity Name
Paterson Counseling Center, Inc.
Subdivision Name
Ryan White Program
Type
Ryan White Part A
340B ID
RWI07509
Entity Address
319-321 Main Street
Paterson, NJ 07505
Grant Number
H89HA0026
Participating Start Date
4/1/2019
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
MCDERMOTT PHARMACY
Pharmacy Address
433 UNION AVE
PATERSON, NJ 07502
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Jean Walker, Dir. of HIV Services & Community Outreach
(973) 523-8316 Ext: 7227
Contract Pharmacy Representative
East Orange Pharmacy
Amit Datwani, Partner
(973) 674-5777
Signed By Date
10/15/2021
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