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EDDYSTONE COMMUNITY PHARMACY
RWI07107 Hyacinth Foundation
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Covered Entity Details
Entity Name
Hyacinth Foundation
Subdivision Name
Newark
Type
Ryan White Part A
340B ID
RWI07107
Entity Address
201 Washington Street
Newark, NJ 07102
Grant Number
H89HA00003
Participating Start Date
10/1/2013
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
EDDYSTONE COMMUNITY PHARMACY
Pharmacy Address
1207B CHESTERPIKE
EDDYSTONE, PA 19022
Pharmacy Comments
Contract Details
Approval Date
10/11/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kathy Ahearn-O'Brien, Executive Director
(732) 246-0204
Contract Pharmacy Representative
AIDS Care Group
Eric Strauss, Executive Director
(610) 724-6354
Signed By Date
10/11/2013
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