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UNITED DRUGS
RWI07101 Rutgers, The State University of New Jersey
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Covered Entity Details
Entity Name
Rutgers, The State University of New Jersey
Subdivision Name
RBHS-New Jersey Medical School
Type
Ryan White Part A
340B ID
RWI07101
Entity Address
140 Bergen Street
ACC, D- Level, Room D1725
Newark, NJ 07103-0000
Grant Number
H89HA00003
Participating Start Date
1/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
UNITED DRUGS
Pharmacy Address
507 CENTRAL AVE
NEWARK, NJ 07107-1466
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles Hathaway, Asst Director ORSP
(973) 972-0283
Contract Pharmacy Representative
United Drugs
Siva Tallvajhala, President
(973) 528-8510
Signed By Date
1/12/2018
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