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LIVINGSTON INFUSION CARE INC
DSH310014 THE COOPER HEALTH SYSTEM DBA COOPER UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
THE COOPER HEALTH SYSTEM DBA COOPER UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310014
Entity Address
ONE COOPER PLAZA
CAMDEN, NJ 08103
Medicare Provider Number
310014
Participating Start Date
1/1/2005
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
LIVINGSTON INFUSION CARE INC
Pharmacy Address
RWJBARNABAS HEALTH INFUSION AND SPECIALT
603 MONTROSE AVE
SOUTH PLAINFIELD, NJ 07080
Pharmacy Comments
02/22/2013 name change (was DISCOVER RX INFUSION & SPECIALTY PHARMAC); 11/15/2012 DEA update (was LIVINGSTON INFUSION PHARMACY)
Contract Details
Approval Date
1/14/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Douglas E. Shirley, Senior Executive VP and CFO
(856) 342-2443
Contract Pharmacy Representative
Suzanne Sesta, Vice President
(908) 851-7420
Signed By Date
1/14/2016
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