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ATLANTICARE PHARMACY
CH02771C ATLANTICARE HEALTH SERVICES INC
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Covered Entity Details
Entity Name
ATLANTICARE HEALTH SERVICES INC
Subdivision Name
ATLANTICARE HEALTH SERVICES -COVENANT HOUSE
Type
HRSA-Funded Health Center
340B ID
CH02771C
Entity Address
929 Atlantic Ave
Atlantic City, NJ 08401-7401
Grant Number
H80CS00858
Participating Start Date
4/1/2017
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ATLANTICARE PHARMACY
Pharmacy Address
ATLANTICARE REGIONAL MEDICAL CENTER
1401 ATLANTIC AVE
SUITE 1000
ATLANTIC CITY, NJ 08401-7022
Pharmacy Comments
Contract Details
Approval Date
3/7/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Atlanticare
Steven Moscola, AVP Ambulatory Pharmacy Services
(609) 404-7443
Signed By Date
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