Contract Pharmacy Details

GENOA HEALTHCARE LLC
STD071033 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

Sexually Transmitted Diseases

340B ID

STD071033

Entity Address

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

Grant Number

NH25PS005174-06

Participating Start Date

10/1/2019

Last Recertification Date

5/9/2024

Pharmacy Details

Pharmacy Name

GENOA HEALTHCARE LLC

Pharmacy Address

25 E SALEM STREET
HACKENSACK, NJ 07601

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