Contract Pharmacy Details

HACKENSACK MERIDIAN HEALTH PHARMACY @ JE
RWII07753 HMH Hospitals Corporation

Entity Name

HMH Hospitals Corporation

Subdivision Name

Jersey Shore University Medical Center

Type

Ryan White Part B

340B ID

RWII07753

Entity Address

1828 West Lake Ave
Neptune, NJ 07753

Grant Number

X07HA00017

Participating Start Date

4/1/2024

Last Recertification Date

Pharmacy Name

HACKENSACK MERIDIAN HEALTH PHARMACY @ JE

Pharmacy Address

UNIVERSITY MEDICAL CENTER
1945 NJ-33
NEPTUNE, NJ 07753

Pharmacy Comments

Approval Date

4/10/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Renita Luke, Director
(732) 233-8719

Signed By Date

4/10/2024

Contract Pharmacy Representative

Hackensack Meridian Health
Eklavya Lalwani, Pharmacy Manager
(732) 776-4750