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BARNABAS HEALTH RETAIL PHARMACY
DSH310002 NEWARK BETH ISRAEL MEDICAL CENTER
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Covered Entity Details
Entity Name
NEWARK BETH ISRAEL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310002
Entity Address
201 LYONS AVENUE
NEWARK, NJ 07112
Medicare Provider Number
310002
Participating Start Date
10/1/2004
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
BARNABAS HEALTH RETAIL PHARMACY
Pharmacy Address
BARNABAS HEALTH RETAIL PHARMACY
201 LYONS AVE
NEWARK, NJ 07112
Pharmacy Comments
Contract Details
Approval Date
12/1/2010
Contract Begin Date
12/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOHN BRENNAN, EXECUTIVE DIRECTOR
(973) 926-7850
Contract Pharmacy Representative
Joe Voelkel, Corporate Director Retail Pharmacy
(908) 266-7566
Signed By Date
10/4/2010
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