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INSIGHT CHICAGO, INC
DSH310040 HOBOKEN UNIVERSITY MEDICAL CENTER
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Covered Entity Details
Entity Name
HOBOKEN UNIVERSITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310040
Entity Address
308 WILLOW AVENUE
HOBOKEN, NJ 07030
Medicare Provider Number
310040
Participating Start Date
4/1/2024
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
INSIGHT CHICAGO, INC
Pharmacy Address
2525 S MICHIGAN AVE
CHICAGO, IL 60616-2315
Pharmacy Comments
Contract Details
Approval Date
10/10/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Hughes, Chief Pharmacy Officer
(401) 249-1963
Contract Pharmacy Representative
Insight Hospital and Medical Center Chicago
David Charles Hughes, Chief Pharmacy Officer
(401) 249-1963
Signed By Date
10/10/2024
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