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NEW JERSEY CVS PHARMACY, L.L.C.
CH02007F HENRY J. AUSTIN HEALTH CENTER INC
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Covered Entity Details
Entity Name
HENRY J. AUSTIN HEALTH CENTER INC
Subdivision Name
Henry J. Austin Health Center-Bellevue
Type
HRSA-Funded Health Center
340B ID
CH02007F
Entity Address
433 Bellevue Ave
Trenton, NJ 08618-4514
Grant Number
H80CS00531
Participating Start Date
10/1/2015
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
NEW JERSEY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02870
1240-1248 GREENWOOD AVE
TRENTON, NJ 08609
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/5/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Kemi Alli, Chief Executive Officer
(609) 278-5909
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/17/2023
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