Contract Pharmacy Details

RMC PHARMACY
RWI07101 Rutgers, The State University of New Jersey

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

RMC PHARMACY

Pharmacy Address

AMRITA HEALTHCARE, LLC
236 S ORANGE AVE
NEWARK, NJ 07103-2459

Pharmacy Comments

Contract Details

Approval Date

1/12/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/30/2023
Business decision by covered entity and/or pharmacy

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

340B Drug Pricing Program Database