Contract Pharmacy Details

MEDLY PHARMACY
CH024490 NORTH HUDSON COMMUNITY ACTION CORPORATION

Covered Entity Details

Entity Name

NORTH HUDSON COMMUNITY ACTION CORPORATION

Subdivision Name

North Hudson Community Action Corporation @ West New York

Type

HRSA-Funded Health Center

340B ID

CH024490

Entity Address

5301 BROADWAY
WEST NEW YORK, NJ 07093-2622

Grant Number

H80CS00521

Participating Start Date

1/1/2004

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

MEDLY PHARMACY

Pharmacy Address

MEDLY JERSEY CITY INC
152 NEWARK AVE
JERSEY CITY, NJ 07302

Pharmacy Comments

Contract Details

Approval Date

7/15/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/15/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Rebecca Acosta, Executive Vice President
(201) 210-0100 Ext: 10102

Contract Pharmacy Representative

Medley Pharmacy
Nate Coney, VP
(609) 992-9692

Signed By Date

7/15/2022

340B Drug Pricing Program Database