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NEW JERSEY CVS PHARMACY, L.L.C.
DSH310039 RARITAN BAY MEDICAL CENTER/ HMH HOSPITALS CORPORATION
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Covered Entity Details
Entity Name
RARITAN BAY MEDICAL CENTER/ HMH HOSPITALS CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310039
Entity Address
530 NEW BRUNSWICK AVENUE
PERTH AMBOY, NJ 08861
Medicare Provider Number
310039
Participating Start Date
4/1/2013
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
NEW JERSEY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 02511
557 SOUTH ATLANTIC AVENUE
ABERDEEN, NJ 07747
Pharmacy Comments
Contract Details
Approval Date
1/2/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patricia Carroll, President
(732) 324-5000
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/2/2025
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