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LIVINGSTON INFUSION CARE INC
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
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
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
Suzanne Sesta, Vice President
(908) 851-7420
Signed By Date
1/10/2014
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