Contract Pharmacy Details

GIANNOTTO'S PHARMACY
RWI071020 St James Social Service Corp.

Covered Entity Details

Entity Name

St James Social Service Corp.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI071020

Entity Address

604 DR. MLK. Blvd
Newark, NJ 07102

Grant Number

H89HA00003

Participating Start Date

10/1/2018

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

GIANNOTTO'S PHARMACY

Pharmacy Address

195 1ST AVE W
NEWARK, NJ 07107-2618

Pharmacy Comments

Contract Details

Approval Date

3/13/2022

Contract Begin Date

3/14/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Vesta Godwin Clark, Executive Director
(973) 624-4007 Ext: 110

Contract Pharmacy Representative

Giannotto's Pharmacy
Avani Sheth, Owner
(973) 482-8220

Signed By Date

3/13/2022

340B Drug Pricing Program Database