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COORDINATED CARE NETWORK
DSH310074 JERSEY CITY MEDICAL CENTER
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Covered Entity Details
Entity Name
JERSEY CITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310074
Entity Address
355 GRAND STREET
JERSEY CITY, NJ 07302
Medicare Provider Number
310074
Participating Start Date
4/1/1997
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK
Pharmacy Address
COORDINATED CARE NETWORK
300 PENN CENTER BLVD STE 405
PITTSBURGH, PA 15235-5511
Pharmacy Comments
5/9/11 UPDATED ADDR (WAS SUITE 505)
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carla Hollis, COO
(201) 915-2944
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
1/16/2024
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