Contract Pharmacy Details

JEFFEX, INC.
DSH390174 THOMAS JEFFERSON UNIVERSITY HOSPITAL

Covered Entity Details

Entity Name

THOMAS JEFFERSON UNIVERSITY HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH390174

Entity Address

111 South 11th Street
Philadelphia, PA 19107

Medicare Provider Number

390174

Participating Start Date

4/1/2006

Last Recertification Date

9/8/2024

Pharmacy Details

Pharmacy Name

JEFFEX, INC.

Pharmacy Address

ALSO KNOWN AS JEFFERSON APOTHECARY
111 S 11TH ST STE 1850
PHILADELPHIA, PA 19107-4824

Pharmacy Comments

Contract Details

Approval Date

5/3/2016

Contract Begin Date

5/12/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

NEIL G. LUBARSKY, SR VP FOR FINANCE
(215) 955-9993

Contract Pharmacy Representative

Thomas Jefferson University Hospitals
Bill Balas, Assistant Director of Outpatient Pharmacy
(215) 955-9218

Signed By Date

5/3/2016

340B Drug Pricing Program Database