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PFSP ( PATIENT FIRST SERVICES PHARMACY )
STD07103 North Jersey AIDS Alliance, Inc d.b.a. North Jersey Community Research Initiative (NJCRI)
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Covered Entity Details
Entity Name
North Jersey AIDS Alliance, Inc d.b.a. North Jersey Community Research Initiative (NJCRI)
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD07103
Entity Address
393 Central Ave
Newark, NJ 07103
Grant Number
NU62PS924524
Participating Start Date
10/1/2016
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
PFSP ( PATIENT FIRST SERVICES PHARMACY )
Pharmacy Address
398 W GRAND AVE
RAHWAY, NJ 07065-3416
Pharmacy Comments
Contract Details
Approval Date
1/30/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/10/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brian McGovern, CEO
(973) 849-0084
Contract Pharmacy Representative
PFSP
Fabian Herrera, CEO
(844) 527-9486
Signed By Date
1/30/2017
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