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LIVINGSTON INFUSION CARE INC
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
LIVINGSTON INFUSION CARE INC
Pharmacy Address
RWJBARNABAS HEALTH INFUSION AND SPECIALT
603 MONTROSE AVE
SOUTH PLAINFIELD, NJ 07080
Pharmacy Comments
02/22/2013 name change (was DISCOVER RX INFUSION & SPECIALTY PHARMAC); 11/15/2012 DEA update (was LIVINGSTON INFUSION PHARMACY)
Contract Details
Approval Date
3/3/2011
Contract Begin Date
3/3/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Qualitas Pharmacy
Suzanne Sesta, Vice President
(908) 226-7450
Signed By Date
2/18/2011
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