Contract Pharmacy Details

GENOA HEALTHCARE LLC
RWI07101 Rutgers, The State University of New Jersey

Covered Entity Details

Entity Name

Rutgers, The State University of New Jersey

Subdivision Name

RBHS-New Jersey Medical School

Type

Ryan White Part A

340B ID

RWI07101

Entity Address

140 Bergen Street
ACC, D- Level, Room D1725
Newark, NJ 07103-0000

Grant Number

H89HA00003

Participating Start Date

1/1/2015

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

GENOA HEALTHCARE LLC

Pharmacy Address

93 WEST PALISADE AVE, ROOM 128
ENGLEWOOD, NJ 07631

Pharmacy Comments

Contract Details

Approval Date

10/15/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Letitia Dean, Assistant Director, Office of Research and Sponsored Programs
(973) 972-0283

Contract Pharmacy Representative

Optum
Avani Patel, VP, 340B Operations
(763) 330-5555

Signed By Date

10/15/2024

340B Drug Pricing Program Database