340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
870 SOUTHERN DRUG CORP
RWI07103 North Jersey AIDS Alliance dba North Jersey Community Research Initiative (NJCRI)
Print
Covered Entity Details
Entity Name
North Jersey AIDS Alliance dba North Jersey Community Research Initiative (NJCRI)
Subdivision Name
Type
Ryan White Part A
340B ID
RWI07103
Entity Address
393 Central Avenue
Newark, NJ 07103
Grant Number
H89HA00003
Participating Start Date
7/1/2013
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
870 SOUTHERN DRUG CORP
Pharmacy Address
D/B/A AVITA PHARMACY 1064
924 MYRTLE AVE
BROOKLYN, NY 11206
Pharmacy Comments
Contract Details
Approval Date
7/12/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brian McGovern, CEO
(973) 849-0084
Contract Pharmacy Representative
Javier Alandete, Regional Director
(724) 779-4720 Ext: 027
Signed By Date
7/12/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session