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MAIN FAIR PHARMACY
STD07505 Coalition on AIDS in Passaic County
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Covered Entity Details
Entity Name
Coalition on AIDS in Passaic County
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD07505
Entity Address
100 Hamilton Plaza
Suite 1406
Paterson, NJ 07505
Grant Number
NH25PS0051740508
Participating Start Date
4/1/2018
Last Recertification Date
5/19/2025
Pharmacy Details
Pharmacy Name
MAIN FAIR PHARMACY
Pharmacy Address
87 MAIN ST
PATERSON, NJ 07505
Pharmacy Comments
Contract Details
Approval Date
4/1/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jerry C Dillard, Executive Director
(973) 742-6742 Ext: 305
Contract Pharmacy Representative
Nota Consulting Group, LLC
Fungisai Nota, 340B Program Manager
(610) 742-7763
Signed By Date
4/1/2024
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