Contract Pharmacy Details

MOLNAR PHARMACY
RWI07960A New Jersey AIDS Services

Covered Entity Details

Entity Name

New Jersey AIDS Services

Subdivision Name

The Eric Johnson House

Type

Ryan White Part A

340B ID

RWI07960A

Entity Address

44 South Street
Morristown, NJ 07960

Grant Number

H89HA00003

Participating Start Date

4/1/2017

Last Recertification Date

2/7/2018

Entity Termination Date

4/1/2019

Pharmacy Details

Pharmacy Name

MOLNAR PHARMACY

Pharmacy Address

MORRISTOWN PHARMACY LLC
76 MORRIS STREET
MORRISTOWN, NJ 07960

Pharmacy Comments

Contract Details

Approval Date

4/1/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Laurie Litt, Chief Executive Officer
(973) 285-0006 Ext: 15

Contract Pharmacy Representative

Pharmacy
Hyman Sharp, Pharmacy Manager
(973) 551-4895

Signed By Date

4/1/2018

340B Drug Pricing Program Database