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BARNABAS HEALTH RETAIL PHARMACY
RWI07306 JERSEY CITY MEDICAL CENTER
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Covered Entity Details
Entity Name
JERSEY CITY MEDICAL CENTER
Subdivision Name
DENTAL CLINIC
Type
Ryan White Part A
340B ID
RWI07306
Entity Address
418 SUMMIT AVENUE
JERSEY CITY, NJ 07306
Grant Number
H89HA00003
Participating Start Date
7/1/2013
Last Recertification Date
2/17/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
BARNABAS HEALTH RETAIL PHARMACY
Pharmacy Address
BARNABAS HEALTH RETAIL PHARMACY
355 GRAND ST
JERSEY CITY, NJ 07302
Pharmacy Comments
Contract Details
Approval Date
1/10/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
JOSEPH F. SCOTT, PRESIDENT & CEO
(201) 521-5925
Contract Pharmacy Representative
Kenneth Markakis, pharmacist-in-charge
(201) 915-2166
Signed By Date
1/10/2014
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