Contract Pharmacy Details

BOSWELL PHARMACY SERVICES, LLC
DSH310021 St Francis Medical Center

Covered Entity Details

Entity Name

St Francis Medical Center

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH310021

Entity Address

601 Hamilton Ave
Trenton, NJ 08629

Medicare Provider Number

310021

Participating Start Date

4/1/2014

Last Recertification Date

8/25/2022

Entity Termination Date

1/1/2023

Pharmacy Details

Pharmacy Name

BOSWELL PHARMACY SERVICES, LLC

Pharmacy Address

131 SCHOOLHOUSE ROAD
P O BOX 266
JENNERSTOWN, PA 15547

Pharmacy Comments

Contract Details

Approval Date

4/13/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Mark Kelly, VP Finance/CFO
(609) 599-5119 Ext: 5119

Contract Pharmacy Representative

BosWell Pharmacy Services
Jacqueline M Martella, pharmacist
(888) 688-3288

Signed By Date

4/13/2022

340B Drug Pricing Program Database