Contract Pharmacy Details

WALMART PHARMACY 10-5169
CH027000 Central Jersey Medical Center Inc.

Covered Entity Details

Entity Name

Central Jersey Medical Center Inc.

Subdivision Name

Central Jersey Medical Center Inc.

Type

HRSA-Funded Health Center

340B ID

CH027000

Entity Address

275 Hobart St
Perth Amboy, NJ 08861-4310

Grant Number

H80CS00253

Participating Start Date

1/1/2005

Last Recertification Date

3/1/2025

Pharmacy Details

Pharmacy Name

WALMART PHARMACY 10-5169

Pharmacy Address

2252 NORTH 8TH STREET
SUITE A
ROGERS, AR 72756

Pharmacy Comments

Contract Details

Approval Date

1/10/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Thomas Boggiano, Chief Financial Officer
(732) 376-6659

Contract Pharmacy Representative

Walmart
Julie Howard, 340B Program Manager
(479) 277-1498

Signed By Date

1/10/2023

340B Drug Pricing Program Database